Blood Product Use in Recently Diagnosed Persons with Myelodysplastic Syndrome: A Population Study.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4849-4849
Author(s):  
Scott D Ramsey ◽  
Cara L McDermott ◽  
Sara J Beck ◽  
Jose A. Lopez ◽  
Stephen C Dinwiddie ◽  
...  
Keyword(s):  
Myelodysplastic Syndrome ◽  
Blood Product ◽  
Puget Sound ◽  
Washington State ◽  
Red Blood Cell Transfusion ◽  
Refractory Anemia ◽  
Newly Diagnosed ◽  
Blood Products ◽  
Product Use ◽  
Western Washington

Abstract Abstract 4849 Many patients with myelodysplastic syndrome (MDS) experience cytopenias that require blood product support. The extent to which MDS patients utilize blood products following diagnosis is unknown. The objective of this study was to characterize the use of blood products among recently diagnosed MDS patients in western Washington State. Records from the NCI's Surveillance, Epidemiology, and End Results (SEER) cancer registry for western Washington State were searched for patients diagnosed with MDS between 2001 and 2007. These records were linked to Puget Sound Blood Center (PSBC) database records. The PBSC is the major supplier of blood products for the Washington SEER region. SEER identified a total of 781 newly diagnosed patients during 2001-2007. The average age was 72.84, 76% were over age 65 and 55% were over age 75. Fifty-eight percent were male and 88% were white race. The most common MDS subtypes included refractory anemia (24%) and refractory anemia with excess blasts (21%); 33% had no specified subtype. Three hundred seventy-six patients (48%) received at least one blood product within 12 months of diagnosis; packed red blood cells (RBCs) (n=361 persons) and platelets (n=222 persons) were most commonly transfused. Among those receiving at least one transfusion of RBCs or one transfusion of platelets respectively, patients received an average of 15.40 units of RBCs and 15.37 units of platelets over 12 months from diagnosis; of these patients, the highest quartile used an average of 39.84 RBCs and 33.81 platelets per person. The proportion of MDS patients receiving any RBCs within 12 months of diagnosis increased from 24% in 2001 to 54% in 2007. Platelet use within 12 months of diagnosis increased from 12% of patients in 2001 to 39% in 2007. Among those receiving at least one platelet transfusion or at least one red blood cell transfusion within 12 months of diagnosis the number of products transfused increased over time, from an average of 8.00 platelet units (SD 5.77) and 8.85 units of RBCs (SD 11.21) in 2001 to 14.12 platelet units (SD 20.31) and 15.98 units RBCs (SD 19.35) in 2007 (p<0.0001, p<0.0001, respectively). Approximately half of newly diagnosed MDS patients receive at least one blood product in the first 12 months following diagnosis. Blood product use has increased substantially from 2001 to 2007, in terms of both the proportion of patients receiving them and the number of transfusions per person. Further study is needed to determine the factors leading to more aggressive use of blood products in these patients. Disclosures No relevant conflicts of interest to declare.

scholarly journals The Impact of Perioperative Viscoelastic Test Application on Blood Product Usage and Outcome in Cardiac Surgery; Regional Cardiac Surgery Center Experience

2021 ◽  
Author(s):  
Murat Aksun ◽  
Saliha Aksun ◽  
Mehmet Ali Çoşar ◽  
Elif Neziroğlu ◽  
Senem Girgin ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Clinical Experience ◽  
Heart Surgery ◽  
Blood Product ◽  
Open Heart Surgery ◽  
Control Group ◽  
Open Heart ◽  
Blood Products ◽  
Product Use ◽  
The Impact

Objective: Thromboelastography (TEG) is a diagnostic modality that gives information about coagulation. Despite all blood-preserving precautions in open heart surgery there are blood losses and the use of blood and blood products becomes inevitable. TEG is mostly not available in every center and habits, trends and clinical experience in blood use create the possibility of causing unnecessary use of blood and blood products. In this study, it was aimed to determine the effect of the use of thromboelastography on the use of blood and blood products in cardiac surgery. Methods: Two hundred patients between 18-70 years old who underwent open heart surgery were included in the study. After the cardiopulmonary bypass (CPB), the cases were confirmed to have an Activated Clotting Time (ACT) value in the range of 120-150 sec after protamine administration. In 100 patients in the TEG group, the coagulation status was evaluated with TEG and it was decided how to apply blood and blood product use. Blood and blood product use was applied to 100 patients in the control group based on clinical experience and foresight. The total amount of blood and blood product used, fluid balance, need for inotropics, mechanical ventilator time, complications, duration of intensive care and discharge times were recorded. Results: Use of Fresh Frozen Plasma (FFP) at the after CPB in the TEG group was statistically significantly lower than that of the control group FFP (p<0.05). Postoperative FFP and postoperative platelet use in the study group were statistically significantly lower than in the postoperative FFP and postoperative platelet values of the control group (p <0.05). Conclusion: The use of thromboelastography is a very useful monitoring in terms of reducing FFP use after CPB and reducing FFP and platelet usage in the postoperative period. In this way, the unnecessary use of blood and blood products can be prevented.

Blood product support

2007 ◽  
pp. 501-510
Keyword(s):  
Blood Product ◽  
Intensive Chemotherapy ◽  
Blood Products ◽  
Product Use ◽  
Remission Rates ◽  
Nurses Role ◽  
British Committee

Blood products 502 The nurses' role in blood product transfusions 508 The introduction of safe, reliable blood products has enabled the development of intensive chemotherapy programmes for a variety of malignancies. This has led to significantly improved remission rates. It must be remembered however that blood product use is not without risks, and that these are a very expensive resource. The pool of acceptable donors is also diminishing because of more stringent screening. Blood products should only be used in appropriate situations in consultation with national and local guidelines. (See British Committee for Standards in Haematology, BCSH...

Stimulation of Hematopoiesis by Amifostine in Patients With Myelodysplastic Syndrome

Blood ◽  
1997 ◽  
Vol 90 (9) ◽  
pp. 3364-3369 ◽  
Author(s):  
Alan F. List ◽  
Farah Brasfield ◽  
Ruth Heaton ◽  
Betty Glinsmann-Gibson ◽  
Linda Crook ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Myelodysplastic Syndrome ◽  
Dose Schedule ◽  
Treatment Withdrawal ◽  
Red Blood Cell Transfusion ◽  
Refractory Anemia ◽  
Hematopoietic Progenitors ◽  
Absolute Increase ◽  
Hematological Effects

Abstract The aminothiol, amifostine (Ethyol; U.S. Bioscience, West Conshohocken, PA), is a cytoprotective agent that ameliorates the toxicities of anticancer therapy. In vitro, amifostine promotes the formation and survival of primitive hematopoietic progenitors derived from myelodysplastic bone marrow (BM) specimens. To evaluate the hematological effects of amifostine, 18 patients with myelodysplastic syndrome (MDS) and one or more refractory cytopenias received treatment with amifostine in a Phase I/II study. Four cohorts received intravenous treatment with 100, 200, or 400 mg/m2 amifostine three times a week, or 740 mg/m2 weekly for three consecutive weeks followed by 2 weeks observation. Nonresponding patients received a second course of therapy at the next higher dose level depending upon drug tolerance. Bone marrow (BM) progenitor growth was assessed before treatment and after day 21. Diagnoses included refractory anemia (7), refractory anemia with ringed sideroblasts (5), refractory anemia with excess blasts (RAEB) (4), and RAEB-in transformation (RAEB-t) (2). Single- or multi-lineage hematologic responses occurred in 15 patients (83%) treated with the three-times-a-week dose schedule. Fourteen patients had a 50% or greater increase in absolute neutrophil count with amifostine treatment (range, 426 to 11,348/μL). Platelet count increased in 6 (43%) of 14 patients with thrombocytopenia (absolute increase, 16,000 to 110,000/μL), and 5 of 15 red blood cell transfusion-dependent patients had a 50% of greater reduction in transfusion needs. Assayable hematopoietic progenitors increased in 13 of 15 evaluable patients; including CFU-GEMM (12), BFU-E (8), and CFU-GM (6). Amifostine doses less than or equal to 200 mg/m2 were well tolerated, whereas grade II nausea, vomiting, and fatigue was limiting at higher doses. Three patients with excess blasts before enrollment experienced an increase in BM blast percentage and two patients had evolution to acute leukemia that persisted after treatment withdrawal. We conclude that amifostine administered at doses ≤200 mg/m2 three times a week is well tolerated and has hematologic activity in patients with MDS.

Cytogenetic Features and Prognosis In Argentinean Patients with Myelodysplastic Syndrome: a Multicenter Study

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 1888-1888
Author(s):  
Carolina Belli ◽  
Raquel Bengió ◽  
Pedro Negri Aranguren ◽  
Francisco Sakamoto ◽  
María Gabriela Flores ◽  
...  
Keyword(s):  
Myelodysplastic Syndrome ◽  
Cumulative Risk ◽  
World Health ◽  
Red Blood Cell Transfusion ◽  
Refractory Anemia ◽  
Published Data ◽  
Abnormal Karyotype ◽  
Transfusion Requirements ◽  
Cytogenetic Profile ◽  
The Impact

Abstract Abstract 1888 Myelodysplastic Syndrome (MDS) comprises a group of heterogeneous hematological disorders with variable risk of leukemic evolution (LE) and short survival (SV). Around 40–50% of patients show abnormal karyotype at diagnosis and cytogenetic findings are an independent prognostic factor in MDS. Although the International Prognostic Scoring System (IPSS) differentiated 3 cytogenetic categories of risk (CCR), the Intermediate one is heterogeneous. The aim of this study was to characterize the cytogenetic profile, to test its prognostic value and to evaluate cytogenetic groups of risk in the Argentinean MDS population. Also, we tried to ascertain whether some abnormalities could be segregated from their respective CCR. This is a multicenter retrospective analysis of 488 primary Argentinean patients with MDS evaluated from 1984 to 2008 (including 183 patients from the Pilot Study for MDS Registry organized by the Argentinean Society of Hematology). Patients' distribution according to French-American-British classification (FAB) was: 235 Refractory Anemia (RA), 50 RA with Ringed Sideroblasts (RARS), 121 RA with excess of Blast (RAEB), 27 RAEB in transformation (RAEBt) and 55 Chronic Myelomonocytic Leukemia (CMML). The median age was 69 (17-92) years with a gender ratio (M/F) of 1.3. During the follow-up (mean: 25 months (m), range: 1–266 m), 110 (22.5%) underwent LE and 217 (44.5%) patients died. Age, sex, percentage of bone marrow blast, hemoglobin level, platelets count, number of cytopenias, LDH level and red blood cell transfusion requirements were significant predictive variables for prognosis (Kaplan-Meier and Long-Rank test, p<0.05). FAB and World Health Organization (WHO) classifications and scoring systems (Lille, Lausanne-Bournemouth, IPSS, GCECGH and WPSS) allowed us to differentiate groups of risk for SV and LE. Cytogenetic results were available in 421 patients and 176 (42%) showed abnormal karyotype. Cytogenetic profile showed that all chromosomes were involved and different cytogenetic alterations were found (total or partial chromosome losses were predominant). The most common cytogenetic aberrations were: -5/5q- (20% among cases with abnormal karyotype), -7/7q- (16%), +8 (20%), 20q- (9%) and –Y (8%). No particular aberration was associated to any FAB subtype though the frequency of abnormal karyotypes increased from 36% for RA, 39% RARS, 50% RAEB to 74% RAEBt and 39% for LMMC. Karyotypes were further divided according to IPSS CCR into 68% Good, 21% Intermediate and 12% Poor with median SV of 48, 34 and 17m and a LE cumulative risk to 1-year: 13%, 25% and 38%, respectively, p<0.0001. CCR were also predictive in the WHO classified population (p<0.0001 for SV and p=0.0021 for LE). Patients with normal karyotype had better outcome than those with cytogenetic alterations (median SV of 51 vs. 21 m, p=0.0012, and LE cumulative risk to 1-year: 13% vs. 26%, p=0.0047). When we tried to ascertain whether some alterations could be segregated from their respective Good and Poor CCR, no significant differences were observed both for SV and for LE. However, the outcome of the Intermediate CCR was heterogeneous ranging between patients with 12p- (median SV: 65 m and a LE cumulative risk to 1-year: 0%) and those with rearrangements 3q/ del(17p)/ +19/ t(11)(q23) (median SV: 15 m and a LE cumulative risk to 1-year: 48%, p=0.0220). Cytogenetic findings had a clear impact on SV and LE in our population and results in the present series, the largest in Latin America, are coincident with published data. However, the wide spectrum of low frequency aberrations stresses the importance of large study groups where the impact of such aberrations could be statistically evaluated to properly segregate them from their original CCR. Disclosures: No relevant conflicts of interest to declare.

Seismic reflection images beneath Puget Sound, western Washington State: The Puget Lowland thrust sheet hypothesis

1997 ◽  
Vol 102 (B12) ◽  
pp. 27469-27489 ◽  
Author(s):  
Thomas L. Pratt ◽  
Samuel Johnson ◽  
Christopher Potter ◽  
William Stephenson ◽  
Carol Finn
Keyword(s):  
Seismic Reflection ◽  
Puget Sound ◽  
Washington State ◽  
Thrust Sheet ◽  
Western Washington

GIS-Based Logistic Regression for Landslide Susceptibility Analysis in Western Washington State

2017 ◽  
Vol 8 (2) ◽  
pp. 1-19 ◽  
Author(s):  
Lucas A. Dailey ◽  
Sven Fuhrmann
Keyword(s):  
Logistic Regression ◽  
Landslide Susceptibility ◽  
Puget Sound ◽  
Washington State ◽  
Susceptibility Map ◽  
The North ◽  
Susceptibility Maps ◽  
Western Washington ◽  
Landslide Susceptibility Maps ◽  
Puget Sound Region

The Oso landslide, one of the most recent disasters, occurred on March 22nd, 2014 in western Washington State. It caused significant property damage and killed over 40 people. As a result, a renewed interest has emerged for creating more accurate landslide susceptibility maps for this region. Research addressing landslide susceptibility within the north Puget Sound region of western Washington is lacking; therefore, this study develops a probabilistic GIS-based landslide susceptibility model for the north Puget Sound region. Multivariate logistic regression was utilized to create a landslide susceptibility map of Whatcom, Skagit, Snohomish, and King Counties. To predict probable areas of landslide occurrence, a landslide inventory map was prepared and fourteen topographic, geologic, environmental, and climatic predictor variables were considered. This research aims to assist in restructuring western Washington's landslide policies, and could serve as the first step in producing more accurate landslide susceptibility maps for the region.

scholarly journals Knowledge of appropriate blood product use in perioperative patients among clinicians at a tertiary hospital

2016 ◽  
Vol 21 ◽  
pp. 309-314 ◽  
Author(s):  
Bradley Yudelowitz ◽  
Juan Scribante ◽  
Helen Perrie ◽  
Eddie Oosthuizen
Keyword(s):  
General Surgery ◽  
Orthopaedic Surgery ◽  
Blood Product ◽  
Current Knowledge ◽  
Tertiary Hospital ◽  
Fresh Frozen Plasma ◽  
Blood Products ◽  
Product Use ◽  
Infectious Risk ◽  
Obstetrics And Gynaecology

Background: Blood products are an expensive and scarce resource with inherent risks to patients. The current knowledge of rational blood product use among clinicians in South Africa is unknown.Purpose of research: To describe the level of clinicians' knowledge related to all aspects of the ordering and administration of blood products from the South African Blood Services for peri-operative patients at a tertiary hospital.Method: A self-administered survey was distributed to 210 clinicians of different experience levels from the departments of Anaesthesiology, General Surgery and Trauma, Orthopaedic Surgery and Obstetrics and Gynaecology at the study hospital. The questions related to risks, cost, ordering procedures and transfusion triggers for red cell concentrate (RCC), fresh frozen plasma (FFP) and platelets.Results: A total of 172 (81.90%) surveys were returned. The overall mean for correctly answered questions was 16.76 (±4.58). The breakdown by specialty was: Anaesthesiology 19.98 (±3.84), General Surgery and Trauma 16.28 (±4.05), Orthopaedic Surgery 13.83 (±4.17) and Obstetrics and Gynaecology 15.63 (±3.51). Anaesthesiology performed better than other disciplines (p < 0.001) and consultants out-performed their junior colleagues (p < 0.001). Seventy percent correctly identified triggers for RCC transfusion and 50% for platelets. Administration protocols were correctly defined by 80% for RCC and FFP just over 50% for platelets. Thirty eight percent of respondents deemed infectious and non-infectious risk sufficient to obtain informed consent. Knowledge of costs and ordering was below 30%.Conclusion: Clinician's knowledge of risks, resources, costs and ordering of blood products for perioperative patients is poor. Transfusion triggers and administration protocols had an acceptable correct response rate.

scholarly journals Patterns of blood product use among patients with myelodysplastic syndrome

Vox Sanguinis ◽  
2011 ◽  
Vol 102 (4) ◽  
pp. 331-337 ◽  
Author(s):  
S. D. Ramsey ◽  
J. S. McCune ◽  
D. K. Blough ◽  
C. L. McDermott ◽  
S. J. Beck ◽  
...  
Keyword(s):  
Myelodysplastic Syndrome ◽  
Blood Product ◽  
Product Use

Effect of tranexamic acid administration time on blood product use in urban trauma patients

2020 ◽  
Vol 77 (Supplement_2) ◽  
pp. S46-S53 ◽  
Author(s):  
Elizabeth Tencza ◽  
Andrew J Harrell ◽  
Preeyaporn Sarangarm
Keyword(s):  
Tranexamic Acid ◽  
Blood Product ◽  
Trauma Patients ◽  
Loading Dose ◽  
Blood Products ◽  
Ambulance Personnel ◽  
Product Usage ◽  
Packed Red Blood Cells ◽  
Product Use ◽  
Acid Administration

Abstract Purpose To evaluate the effect of time to tranexamic acid administration on blood product usage in trauma patients and to assess the potential benefit of initiating a protocol for field administration by ground ambulance personnel. Methods Adult patients with traumatic injuries who received 1 g of tranexamic acid during the period January 2014 through June 2016 were retrospectively identified via review of automated dispensing cabinet and electronic medical record data and cross-referencing with the New Mexico Trauma Registry. Exclusion criteria included tranexamic acid use for nontrauma indications, previous admission for trauma during the study period, and a lack of pertinent information regarding the time, type, or severity of trauma in available records. The primary outcome was blood product use (aggregate of units of platelets, packed red blood cells [pRBCs], and fresh frozen plasma [FFP]) in the first 24 hours of hospital admission. Results The analysis included 107 patient cases, with a median transport time of 20 minutes (range, 7-103 minutes); 73% of reported transport times were less than 30 minutes. All patients received a loading dose of tranexamic acid in the hospital, with the exception of 2 patients who received tranexamic acid in the field. Administration of a tranexamic acid loading dose was documented within 3 hours for 90.7% of patients, with a mean time to administration of 91.9 minutes. A mean (SD) total of 14.8 (16.0) units of blood products (range, 0-91 units) were administered, consisting of a mean (SD) of 8.0 (8.4) units of pRBCs (range, 0-48 units), 5.6 (7.5) units of FFP (range, 0-38 units), and 1.2 (1.7) units of platelets (range, 0-7 units). Time to tranexamic acid administration did not affect blood product usage in the first 24 hours of admission after adjusting for potential confounders. Conclusion Earlier administration of tranexamic acid was not associated with a decrease in use of blood products. This finding, paired with the relatively short ground transport times typical for our institution, makes it unlikely that field administration of tranexamic acid would benefit the evaluated patient population.

Predictive Factors for High Blood Product Use in Patients with Acute Stanford Type A Dissection

2020 ◽  
Author(s):  
M. J. Schafigh ◽  
M. Hamiko ◽  
W. Schiller ◽  
H. Treede ◽  
C. Probst
Keyword(s):  
Predictive Factors ◽  
Blood Product ◽  
Type A ◽  
Product Use ◽  
Type A Dissection
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