scholarly journals Pre-transplant red blood cell and platelet transfusion burden in de novo myelodysplastic syndrome undergoing allogeneic transplantation

2021 ◽  
Author(s):  
Takaaki Konuma ◽  
Jun Aoki ◽  
Yukiyasu Ozawa ◽  
Naoyuki Uchida ◽  
Takeshi Kobayashi ◽  
...  
Keyword(s):  
Blood Cell ◽  
Myelodysplastic Syndrome ◽  
Red Blood Cell ◽  
Platelet Transfusion ◽  
De Novo ◽  
Allogeneic Transplantation

scholarly journals Myelodysplastic syndrome: the other cause of anemia in end-stage renal disease patients undergoing dialysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Min-Yu Chang ◽  
Sheng-Fung Lin ◽  
Shih-Chi Wu ◽  
Wen-Chi Yang
Keyword(s):  
Blood Cell ◽  
Renal Disease ◽  
Myelodysplastic Syndrome ◽  
Red Blood Cell ◽  
End Stage Renal Disease ◽  
Refractory Anemia ◽  
Research Database ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract In end-stage renal disease (ESRD) patients receiving dialysis, anemia is common and related to a higher mortality rate. Erythropoietin (EPO) resistance and iron refractory anemia require red blood cell transfusions. Myelodysplastic syndrome (MDS) is a disease with hematopoietic dysplasia. There are limited reports regarding ESRD patients with MDS. We aim to assess whether, for ESRD patients, undergoing dialysis is a predictive factor of MDS by analyzing data from the Taiwan National Health Insurance Research Database. We enrolled 74,712 patients with chronic renal failure (ESRD) who underwent dialysis and matched 74,712 control patients. In our study, we noticed that compared with the non-ESRD controls, in ESRD patients, undergoing dialysis (subdistribution hazard ratio [sHR] = 1.60, 1.16–2.19) and age (sHR = 1.03, 1.02–1.04) had positive predictive value for MDS occurrence. Moreover, more units of red blood cell transfusion (higher than 4 units per month) was also associated with a higher incidence of MDS. The MDS cumulative incidence increased with the duration of dialysis in ESRD patients. These effects may be related to exposure to certain cytokines, including interleukin-1, tumor necrosis factor-α, and tumor growth factor-β. In conclusion, we report the novel finding that ESRD patients undergoing dialysis have an increased risk of MDS.

scholarly journals Safety and Cost Effectiveness of a 10 × 109/L Trigger for Prophylactic Platelet Transfusions Compared With the Traditional 20 × 109/L Trigger: A Prospective Comparative Trial in 105 Patients With Acute Myeloid Leukemia

Blood ◽  
1998 ◽  
Vol 91 (10) ◽  
pp. 3601-3606 ◽  
Author(s):  
Hannes Wandt ◽  
Markus Frank ◽  
Gerhard Ehninger ◽  
Christiane Schneider ◽  
Norbert Brack ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Myeloid Leukemia ◽  
Platelet Transfusion ◽  
Bleeding Complications ◽  
Group A ◽  
Red Blood Cell Transfusions ◽  
Group B ◽  
Acute Myeloid

Abstract In 105 consecutive patients with de novo acute myeloid leukemia (French-American-British M3 excluded), we compared prospectively the risk of bleeding complications, the number of platelet and red blood cell transfusions administered, and the costs of transfusions using two different prophylactic platelet transfusion protocols. Two hundred sixteen cycles of induction or consolidation chemotherapy and 3,843 days of thrombocytopenia less than 25 × 109/L were evaluated. At the start of the study, each of the 17 participating centers decided whether they would use a 10 × 109/L prophylactic platelet transfusion trigger (group A/8 centers) or a 20 × 109/L trigger (group B/9 centers). Bleeding complications (World Health Organization grade 2-4) during treatment cycles were comparable in the two groups: 20 of 110 (18%) in group A and 18 of 106 (17%) in group B (P = .8). Serious bleeding events (grade 3-4) were generally not related to the patient's platelet count but were the consequence of local lesions and plasma coagulation factor deficiencies due to sepsis. Eighty-six percent of the serious bleeding episodes occurred during induction chemotherapy. No patient died of a bleeding complication. There were no significant differences in the number of red blood cell transfusions administered between the two groups, but there were significant differences in the number of platelet transfusions administered per treatment cycle: pooled random donor platelet concentrates averaged 15.4 versus 25.4 (P < .01) and apheresis platelets averaged 3.0 versus 4.8 (P < .05) for group A versus group B, respectively. This resulted in the cost of platelet therapy being one third lower in group A compared with group B without any associated increase in bleeding risk.

Transfusion Requirements in Nonmyeloablative Allogeneic Stem Cell Transplantation for Hematologic Malignancies.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4178-4178
Author(s):  
Jason W. Brown ◽  
Darrell J. Triulzi
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Platelet Transfusion ◽  
Transfusion Requirement ◽  
Hematologic Malignancies ◽  
Packed Red Blood Cells ◽  
Transfusion Requirements ◽  
Cell Transplants

Abstract Nonmyeloablative allogeneic stem cell transplants (NM-ASCT) are increasingly being utilized to treat hematologic malignancies in settings where high dose, fully ablative regimens would not be tolerated. We identified 10 male and 13 female patients (n=23) ranging in age from 19 to 63 years old (mean=48) representing all patients whom had undergone NM-ASCT in the last five years. NM-ASCT were performed for acute myelogenous leukemia (n=7), non-Hodgkin’s lymphoma (n=6), Hodgkin’s disease (n=4), multiple myeloma (n=3), myelodysplastic syndrome (n=2), and acute lymphoblastic leukemia (n=1). The majority of patients had undergone at least one previous stem cell transplant (n=16). The mean number of stem cells infused per kilogram at time of transplant was 4.72 X 106 ±1.97 X 106 stem cells and mean time to engraftment was 15.8 ±5.15 days (3 consecutive days with ANC &gt;500). All of the subjects required both platelet and red cell transfusion during the period of analysis. Mean transfusion requirements in the 7 days prior to transplantation were 3.1 ±5.9 units of platelets and 1.2 ±1.5 units of packed red blood cells. Mean platelet transfusion requirements 90 days post transplant were 73.7 ±79.7 units and mean red cell requirements 11.6 ±8.3 units. Total mean transfusion requirements during the time period analyzed were 76.9 ±82.2 units of platelets and 12.8 ±8.9 units of packed red blood cells. There was no significant correlation between the number of stem cells infused per kilogram on day of transplant, the number of previous transplants, or the time to engraftment with red blood cell or platelet transfusion requirements. Our data illustrate a higher proportion of patients requiring platelet transfusions (100% vs. 23%) and red blood cell transfusions (100% vs. 63%) as well as a higher platelet transfusion requirement (median 48 vs. 0 units) and packed red blood cell transfusion requirement (median 11 vs. 2 units) than other authors have reported in a 60 day period in HLA-matched sibling NM-ASCT [Weissinger et al. Blood 98(13):3584-8, 2001]. As is illustrated by the percentage of patients undergoing previous fully ablative stem cell transplants, our patients represent a heavily pretreated population and this may account for the higher transfusion requirements seen in this analysis. Although patients undergoing NM-ASCT receive reduced intensity therapy, in our analysis their transfusion requirements remain substantial.

scholarly journals Safety and Cost Effectiveness of a 10 × 109/L Trigger for Prophylactic Platelet Transfusions Compared With the Traditional 20 × 109/L Trigger: A Prospective Comparative Trial in 105 Patients With Acute Myeloid Leukemia

Blood ◽  
1998 ◽  
Vol 91 (10) ◽  
pp. 3601-3606 ◽  
Author(s):  
Hannes Wandt ◽  
Markus Frank ◽  
Gerhard Ehninger ◽  
Christiane Schneider ◽  
Norbert Brack ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Myeloid Leukemia ◽  
Platelet Transfusion ◽  
Bleeding Complications ◽  
Group A ◽  
Red Blood Cell Transfusions ◽  
Group B ◽  
Acute Myeloid

In 105 consecutive patients with de novo acute myeloid leukemia (French-American-British M3 excluded), we compared prospectively the risk of bleeding complications, the number of platelet and red blood cell transfusions administered, and the costs of transfusions using two different prophylactic platelet transfusion protocols. Two hundred sixteen cycles of induction or consolidation chemotherapy and 3,843 days of thrombocytopenia less than 25 × 109/L were evaluated. At the start of the study, each of the 17 participating centers decided whether they would use a 10 × 109/L prophylactic platelet transfusion trigger (group A/8 centers) or a 20 × 109/L trigger (group B/9 centers). Bleeding complications (World Health Organization grade 2-4) during treatment cycles were comparable in the two groups: 20 of 110 (18%) in group A and 18 of 106 (17%) in group B (P = .8). Serious bleeding events (grade 3-4) were generally not related to the patient's platelet count but were the consequence of local lesions and plasma coagulation factor deficiencies due to sepsis. Eighty-six percent of the serious bleeding episodes occurred during induction chemotherapy. No patient died of a bleeding complication. There were no significant differences in the number of red blood cell transfusions administered between the two groups, but there were significant differences in the number of platelet transfusions administered per treatment cycle: pooled random donor platelet concentrates averaged 15.4 versus 25.4 (P < .01) and apheresis platelets averaged 3.0 versus 4.8 (P < .05) for group A versus group B, respectively. This resulted in the cost of platelet therapy being one third lower in group A compared with group B without any associated increase in bleeding risk.

scholarly journals Red blood cell glucose metabolism in trisomy 10p: possible role of hexokinase in the erythrocyte

Blood ◽  
1983 ◽  
Vol 61 (5) ◽  
pp. 915-919
Author(s):  
M Magnani ◽  
V Stocchi ◽  
E Piatti ◽  
M Dacha ◽  
B Dallapiccola ◽  
...  
Keyword(s):  
Glucose Metabolism ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Glucose Utilization ◽  
De Novo ◽  
Dihydroxyacetone Phosphate ◽  
Cell Fractions ◽  
Cell Glucose ◽  
Normal Controls

Red blood cell glucose metabolism was investigated in a male patient with de novo trisomy 10p. According to previous evidence, when assigning hexokinase gene locus in the 10p11 leads to pter region, a triplex dosage effect of hexokinase activity (HK) was found, while all the other erythrocyte glycolytic enzymes were in the normal values range. Red blood cell glucose utilization was 2.87 mumole/hr/ml RBC as compared to 1.43 in normal controls; the rate of glucose metabolized through the hexose monophosphate shunt (HMPS) was unchanged. Glucose-6- phosphate, fructose-6-phosphate, fructose-1,6-diphosphate, and dihydroxyacetone phosphate increased with respect to normal controls, while normal levels of 3-phosphoglycerate, 2-phosphoglycerate, phosphoenolpyruvate, and ATP were found. The HK activity increased in all the red blood cell fractions obtained by density gradient ultracentrifugation. However, a small difference in the distribution of cells through the gradient was evident. The experiments reported in this article show that in the red blood cells of patients with trisomy 10p, an increased level of HK leads to higher concentrations of glucose- 6-phosphate and to a faster glucose utilization in the Embden-Meyerhof pathway, while the HMPS rate is unchanged.

scholarly journals Red blood cell glucose metabolism in trisomy 10p: possible role of hexokinase in the erythrocyte

Blood ◽  
1983 ◽  
Vol 61 (5) ◽  
pp. 915-919 ◽  
Author(s):  
M Magnani ◽  
V Stocchi ◽  
E Piatti ◽  
M Dacha ◽  
B Dallapiccola ◽  
...  
Keyword(s):  
Glucose Metabolism ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Glucose Utilization ◽  
De Novo ◽  
Dihydroxyacetone Phosphate ◽  
Cell Fractions ◽  
Cell Glucose ◽  
Normal Controls

Abstract Red blood cell glucose metabolism was investigated in a male patient with de novo trisomy 10p. According to previous evidence, when assigning hexokinase gene locus in the 10p11 leads to pter region, a triplex dosage effect of hexokinase activity (HK) was found, while all the other erythrocyte glycolytic enzymes were in the normal values range. Red blood cell glucose utilization was 2.87 mumole/hr/ml RBC as compared to 1.43 in normal controls; the rate of glucose metabolized through the hexose monophosphate shunt (HMPS) was unchanged. Glucose-6- phosphate, fructose-6-phosphate, fructose-1,6-diphosphate, and dihydroxyacetone phosphate increased with respect to normal controls, while normal levels of 3-phosphoglycerate, 2-phosphoglycerate, phosphoenolpyruvate, and ATP were found. The HK activity increased in all the red blood cell fractions obtained by density gradient ultracentrifugation. However, a small difference in the distribution of cells through the gradient was evident. The experiments reported in this article show that in the red blood cells of patients with trisomy 10p, an increased level of HK leads to higher concentrations of glucose- 6-phosphate and to a faster glucose utilization in the Embden-Meyerhof pathway, while the HMPS rate is unchanged.

Therapy of Early Stage Myelodysplastic Syndrome (MDS) with Anti-Thymocyte Globulin (ATG) and Etanercept.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1462-1462
Author(s):  
Bart L. Scott ◽  
Aaron L. Holsinger ◽  
Aaravind Ramakrishnan ◽  
Barry Storer ◽  
Pamela S. Becker ◽  
...  
Keyword(s):  
Blood Cell ◽  
Myelodysplastic Syndrome ◽  
Red Blood Cell ◽  
Early Stage ◽  
Pilot Trial ◽  
Risk Groups ◽  
Red Blood Cell Transfusion ◽  
Transfusion Independence ◽  
Phase 2 Trial ◽  
Soluble Tnf Receptor

Abstract Immunosuppressive therapies have proven valuable in treating ineffective hematopoiesis in patients with Myelodysplastic Syndrome (MDS). Following an encouraging pilot trial, we evaluated the combination of equine anti-thymocyte globulin (ATGAM) and the soluble TNF receptor etanercept in a phase 2 trial. So far 23 patients with MDS (6-RA, 4-RARS, 12-RCMD, 1-RAEB-1) in IPSS risk groups low (n=8) or intermediate-1 (n=15) have been enrolled. All patients were platelet or red blood cell transfusion dependent. Nineteen patients completed therapy with I.V. ATGAM at 40mg/kg/day for four consecutive days, followed by etanercept, 25mg s.c. twice a week for 2 weeks every month for 4 months. The regimen was well tolerated and the majority of adverse events were anticipated infusional reactions related to ATGAM administration. Responses were assessed by modified International Working Group criteria. Twelve patients had hematological improvement (HI)-erythroid, 2 HI-neutrophil, and 3 HI-platelet. Five patients achieved red blood cell and one patient platelet transfusion independence. There was one complete remission in a patient with a co-existing diagnosis of multiple sclerosis. Thus, the overall response rate by intent to treat analysis among the 23 patients was 61%. Four patients did not complete their first course of therapy due to anaphylactic reaction, thrombosis of a pre-existing femoral graft, myocardial infarction, and patient preference. Among patients who completed treatment 74% had a hematological response, with duration of at least 5 months. Combination therapy with ATG and etanercept was active and safe in unselected patients with low and intermediate-1 risk MDS.

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