WHO Bleeding Scale

WHO Bleeding Grade: Standardized oncology toxicity scale. Grade 3 is objectively defined by the requirement for transfusion.

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

Grading the clinical severity of bleeding in patients with thrombocytopenia or coagulation defects.

Standardizing adverse event (AE) reporting in clinical trials.

Monitoring patients receiving high-dose chemotherapy or BMT.

Patient Population

Adult and pediatric patients at risk for hemorrhage.

How it Works

Clinical Thresholds

Grade	Severity	Clinical Features
0	None	Absence of bleeding.
1	Mild	Petechiae, ecchymoses, or mild blood loss (e.g., occasional epistaxis).
2	Moderate	Gross bleeding (clinically significant epistaxis, hematemesis, or melena) but hemodynamically stable.
3	Severe	Bleeding requiring red cell transfusion.
4	Life-threatening	Cerebral, pulmonary, or other massive bleeding leading to hemodynamic instability or death.

Last Comprehensive Review: 2026-07-17

Recent Journal Updates

Cancer MedicineJul 23, 2026

Genomic Alterations and Their Clinical Implications in Pancreatic Ductal Adenocarcinoma in a Large‐Scale Chinese Cohort

Clinical Context

We think this might be relevant to the clinical guidance for WHO Bleeding Scale.

PLOS MedicineJul 21, 2026

Optimising scale-up of injectable lenacapavir for HIV pre-exposure prophylaxis in South Africa: A modelling study and economic evaluation

Clinical Context

We think this might be relevant to the clinical guidance for WHO Bleeding Scale.

British J HaematologyJul 17, 2026

In a nutshell: Explaining joint and muscle bleeding in individuals with haemophilia A and B

Clinical Context

We think this might be relevant to the clinical guidance for WHO Bleeding Scale.

WHO Bleeding Scale

When to Use

When to Use

Patient Population

How it Works

Clinical Thresholds

Clinical Pearls

The Transfusion Pivot

Grade 2 vs 3

The Evidence

Primary Consensus

Reporting results of cancer treatment.

Origins & History

Legacy

Recent Journal Updates

WHO Bleeding Scale

When to Use

When to Use

Patient Population

How it Works

Clinical Thresholds

Clinical Pearls

The Transfusion Pivot

Grade 2 vs 3

The Evidence

Primary Consensus

Reporting results of cancer treatment.

Origins & History

Legacy

Recent Journal Updates