The problem of blood replacement in the individual cancer patient remains unanswered. On present evidence, such a patient must be assumed to be drawn from a population with a mean total blood volume and mean red-cell volume below normal and thus must be assumed to have a better-than-even chance of having a depleted volume. However, it does not necessarily follow that transfusion is necessary; this should ideally be assessed by blood volume determination in each individual case.

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Summary Studies of blood volume in the rat following treatment with large doses of cytotoxic drugs revealed that significant depletion of red cell volume followed the use of cyclophos‐phamide and nitrogen mustard and, to a lesser extent, methotrexate. The anaemia in the case of nitrogen mustard is not revealed by haemoglobin or haematocrit studies, it being masked by hypovolemia following use of the drug. The results indicate that red cells as well as white cells are at risk in cancer chemotherapy.