Causes and Palliation of Transfusion-Associated Vaginal Bleeding in Patients With Metastatic Cancer

Abstract

PURPOSE The current study was undertaken 1) to capture a clinically relevant, systematically-collected series of patients with metastatic cancer and transfusion-associated vaginal bleeding and 2) to provide insight into how best to palliate this bleeding. METHODS/RESULTS As part of a single-institution review, 46 patients with metastatic cancer and transfusion-associated vaginal bleeding were identified. In a minority, 14 (30%), the cancer itself was directly responsible for the bleeding, and, under these circumstances, a gynecological cancer was the most frequent cause. In 13 patients (28%), more than one palliative intervention was attempted. Of all the interventions, a hysterectomy was used most frequently and was successful in 11 patients. The use of ablation or embolization procedures was rarely tried but successful in 4 patients. However, 2 patients died from the vaginal bleeding, despite multiple palliative procedures to control bleeding, including tumor embolization in one. CONCLUSIONS Transfusion-associated vaginal bleeding in patients with metastatic cancer can arise from non-malignant causes, often assumes an uneventful course, but can, at times, be serious and difficult to control.