title: Causes and palliation of transfusion-associated vaginal bleeding in patients with metastatic cancer.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: *Department of Oncology and †Cancer Education Center, Mayo Clinic, Rochester, MN.
authors.forename: Amie E
authors.initials: AE
authors.lastname: Jackson
authors.forename: Elisabeth K
authors.initials: EK
authors.lastname: Stephens
authors.forename: Aminah
authors.initials: A
authors.lastname: Jatoi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000150:complications*; D010166:Palliative Care; D012189:Retrospective Studies; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000209:etiology* / Q000628:therapy; D055815:Young Adult