Causes and palliation of transfusion-associated vaginal bleeding in patients with metastatic cancer

Causes and palliation of transfusion-associated vaginal bleeding in patients with metastatic cancer

Jackson AE; Stephens EK; Jatoi A

International Journal Of Gynecological Cancer

2014

adolescent; Female; Humans; retrospective studies; Young Adult; Palliative Care; Neoplasms; Adult; Aged; Middle Aged; Treatment Outcome; Neoplasm Metastasis; Uterine Hemorrhage

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, gynecological cancer was the most frequent cause. In 13 patients (28%), more than 1 palliative intervention was attempted. Of all the interventions, a hysterectomy was performed 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 of 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 nonmalignant causes and often assumes an uneventful course but can, at times, be serious and difficult to control.

2014-01

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