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Causes and Palliation of Transfusion-Associated Vaginal Bleeding in Patients With Metastatic Cancer
  1. Amie E. Jackson, MD*,
  2. Elisabeth K. Stephens, PhD*, and
  3. Aminah Jatoi, MD*,
  1. *Department of Oncology and
  2. Cancer Education Center, Mayo Clinic, Rochester, MN.
  1. Address correspondence and reprint requests to Aminah Jatoi, MD, Department of Oncology, Mayo Clinic, 200 First St SW, Rochester, MN 55905. E-mail: jatoi.aminah{at}


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.

  • Vaginal bleeding
  • Uterine bleeding
  • Palliation
  • Hemorrhage
  • Anemia

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  • This work was funded by K24CA131099.

  • The authors declare no conflicts of interest.