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Red Cell Transfusion Requirements (red_cell + transfusion_requirement)

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Medical Sciences	100%

Selected Abstracts

Treatment options for hydroxyurea-refractory disease complications in myeloproliferative neoplasms: JAK2 inhibitors, radiotherapy, splenectomy and transjugular intrahepatic portosystemic shunt

EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 3 2010
Elena Mishchenko
Abstract Clinical care of patients with polycythemia vera, essential thrombocythemia and myelofibrosis (MF) requires not only a broad understanding of general treatment principles but also familiarity with the management of hydroxyurea-refractory disease complications. The latter include progressive splenomegaly, symptomatic portal hypertension (e.g. ascites, variceal bleeding), pulmonary hypertension, bone pain, intractable pruritus, constitutional symptoms (e.g. fatigue, night sweats) and cachexia (i.e. loss of lean body mass, general ill health, poor appetite). Some of these symptoms are directly or indirectly related to extramedullary hematopoiesis (EMH) and others to proinflammatory cytokine excess. Results from recent clinical trials of JAK inhibitors suggest remarkable activity in MF-associated constitutional symptoms, cachexia, pruritus and hydroxyurea-refractory splenomegaly. Involved-field radiotherapy is best utilized in the setting of EMH-associated symptoms, including ascites, bone (extremity) pain and pulmonary hypertension. Splenectomy is indicated in the presence of drug-refractory splenomegaly and frequent red cell transfusion requirement. Transjugular intrahepatic portosystemic shunt is used to alleviate symptoms of portal hypertension. [source]

Lack of functional erythropoietin receptors of cancer cell lines

INTERNATIONAL JOURNAL OF CANCER, Issue 5 2008
Magdalena Laugsch
Abstract Erythropoietin (Epo) therapy reduces red cell transfusion requirements and improves the quality of life of anemic cancer patients receiving chemotherapy. However, there is concern that Epo may promote tumor growth. We investigated by real-time RT-PCR, immunofluorescence microscopy, Western blotting and cell growth analysis whether human cancer cell lines (SH-SY5Y, MCF7, HepG2, U2-OS, HeLa, HEK293T, RCC4, HCT116, 7860wt and SW480) possess functional Epo receptors (EpoR). We detected EpoR mRNA in all cell lines. Neither hypoxia nor Epo treatment altered the level of EpoR mRNA expression. Four commonly used commercial antibodies proved to be unsuitable for immunoblot procedures because they cross-reacted with several proteins unrelated with EpoR. Depending on the antibody used, EpoR was localized to the plasma membrane, the cytoplasm or the nucleus. Experiments with small interfering RNA showed that EpoR protein was not expressed by the tumor cells except by UT7/Epo leukemia cells, which served as an EpoR positive control line, and by cells transfected with the human EpoR gene. Apart from UT7/Epo, none of the tumor cell lines responded to Epo treatment with phosphorylation of signaling molecules or with cell proliferation. © 2007 Wiley-Liss, Inc. [source]

The effect of desmopressin on blood loss in patients with rheumatoid arthritis undergoing hip arthroplasty

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2010
K. A. LEINO
Background: Blood loss is an important issue for patients with rheumatoid arthritis undergoing hip surgery. We hypothesised that intraoperative desmopressin treatment would result in a reduction in blood loss in rheumatoid patients undergoing total hip arthroplasty. Methods: Seventy-five patients scheduled for elective total hip arthroplasty were randomised to three groups to receive 0.4 ,g/kg desmopressin (D 0.4), 0.2 ,g/kg desmopressin (D 0.2) or placebo intraoperatively in a double-blind fashion. Blood transfusions were based on calculated safe allowable blood loss and haemoglobin measurements (trigger 90 g/l, 5.59 mmol/l). The primary endpoint was the total blood loss measured till the end of the fourth post-operative day. Secondary endpoints included red cell transfusion requirements and haemoglobin. Results: Total blood loss during the study period was not significantly different between the groups (D 0.4 1829 ± 1068; D 0.2 2240 ± 843 and placebo 2254 ± 1040 ml; P= 0.50). The total amount of red cell transfusions was fewer in group D 0.4 (3.6 ± 1.6 U) when compared with D 0.2 (4.4 ± 1.7 U; P=0.009) and placebo (4.5 ± 2.0 U; P= 0.011) groups. Haemoglobin concentration was lower in the placebo group in the first (5.42 ± 1.16 vs. 5.98 ± 0.47 mmol/l; P=0.033) and the second (6.28 ± 0.66 vs. 6.69 ± 0.47 mmol/l; P=0.033) post-operative mornings compared with group D 0.4. Conclusion: Despite a lack of difference in the primary outcome, total blood loss, intraoperative administration of 0.4 ,g/kg desmopressin resulted in fewer total red cell transfusion requirements in rheumatoid patients undergoing total hip arthroplasty when compared with 0.2 ,g/kg treatment and placebo. [source]