I just had that discussion with my oncologist's NP 2 days ago. Part of their protocol is to consider transfusion if hemoglobin drops below 8.0.

After 11 months on Gemcitabine + Abraxane + Cisplatin, my hemoglobin has steadily declined and has been under 9.0 for 2 months now (8.3 last week) so they're willing to consider transfusion.

I've been living on caffeine most of the year. Just got an Rx for Ritalin last month, which has help with some of the chemo brain fog, but not really done anything for physical endurance (like jogging where I need hemoglobin to help transport oxygen) or even generic shortness of breath.

Two oncologists have been pushing me to go on "maintenance" (lowering or eliminating some of my 3 chemo drugs), pointing out in part that the heavy chemo will just require another transfusion down the road.

I kind of look at it like I've earned a transfusion after a year of this! 😉 More seriously, if my heavy chemo regimen is keeping the cancer under control for now, I don't think a transfusion every 3 months or so is too much to ask.

Have you gotten any insights yet from your doc(s) about this?