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Transfusion 07/2006; 46(6):877. · 3.22 Impact Factor
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Transfusion 05/2006; 46(6):877 - 877. · 3.22 Impact Factor
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American Journal of Hematology 06/2005; 79(1):80. · 4.67 Impact Factor
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ABSTRACT: Transfusion-dependent bone marrow transplant recipients are routinely transfused with ABO group and RhD-compatible blood components. However, because of the scarcity of RhD-negative blood components, particularly platelets, a policy was developed to transfuse RhD-positive blood components to RhD-negative patients during periods of shortage.
We reviewed the records of 78 RhD-negative patients with hematologic malignancies who received RhD-negative bone marrow and/or peripheral blood stem cells, from June 1995 to August 2000. The patients transfused with RhD-incompatible blood components were screened periodically for evidence of the development of red blood cell (RBC) alloimmunization.
Three of 78 patients (4%) developed anti-D antibodies after receiving RhD-incompatible platelet transfusions. One of the patients developed evidence of anti-RhD antibodies after receiving 42 units of RhD-positive random donor platelets; the second patient developed such evidence after receiving 6 apheresis platelets and 2 infusions of intravenous immunoglobulin G (positive for anti-RhD). The third patient received 206 RhD-positive random donor platelets and 5 apheresis units. All patients were discharged from the hospital. The overall immunization rate was 4%. Six patients received Rh-incompatible packed RBCs and showed no evidence of neither anti-RhD nor any other anti-RBC antibodies. All 78 patients had received RhD-incompatible platelets throughout their engraftment period.
Transfusion of RhD-positive blood components to Rh-negative patients with hematologic cancers, who have received RhD-negative bone marrow and/or peripheral blood stem cells, are at low risk of developing RhD antibodies. These findings allow for a flexible strategy of blood component therapy support for this special patient population during periods of shortage.
MedGenMed: Medscape general medicine 02/2004; 6(3):22.
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David S Hong,
Kalen L Jacobson,
Issam I Raad,
Marcos de Lima,
Paolo Anderlini,
Gregory N Fuller,
Cindy Ippoliti,
Rita M Cool,
Norman E Leeds, Aida Narvios,
Xiang Y Han,
Anthony Padula,
Richard E Champlin,
Chitra Hosing
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ABSTRACT: Most human cases of West Nile virus infection are acquired via bites from an infected mosquito. In some cases, infection may also be transmitted by infected blood products or transplanted organs. There have been recent publications suggesting that chemotherapy and immunosuppression may increase a person's risks of developing central nervous system disease if the person is infected with the West Nile virus. Because patients undergoing hematopoietic stem cell transplantation not only are immunocompromised, but also receive multiple blood products, they are at a particularly high risk for acquiring symptomatic disease if exposed to the West Nile Virus. We describe here 2 patients who underwent hematopoietic transplantation at our institution and subsequently developed fatal West Nile virus infections.
Clinical Infectious Diseases 11/2003; 37(8):1044-9. · 9.15 Impact Factor
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ABSTRACT: The purposes of this study are to report experience with transjugular liver biopsy (TJLB) in patients with hematologic malignancy and severe thrombocytopenia and to determine the incidence of hemorrhage-related complications in patients with prebiopsy and pretransfusion platelet counts of 30 x 10(9) /L or lower to propose a threshold platelet count above which TJLB can be safely performed without transfusion.
Medical records and laboratory reports of 50 patients with severe thrombocytopenia who had undergone 51 TJLB procedures and prebiopsy platelet transfusions between August 1999 and September 2001 were retrospectively reviewed. Biopsy success and procedural complications were recorded.
TJLB was technically successful in 49 of 51 procedures (96%). The mean prebiopsy, pretransfusion platelet count was 17 x 10(9)/L (range, 3-30 x 10(9)/L) and a mean of 11 U (range, 6-32 U) of platelets per patient were transfused. The overall mean postbiopsy platelet count was 38 x 10(9)/L (range, 5-105 x 10(9)/L), but it remained 30 x 10(9)/L or lower in 24 TJLB procedures. No hemorrhage-related complications were encountered, but ventricular fibrillation occurred in one patient during the procedure.
A threshold platelet count for safe TJLB resides below 30 x 10(9)/L. A prospective study is necessary to better define a lower threshold above which TJLB can be performed without platelet transfusion.
Journal of Vascular and Interventional Radiology 04/2003; 14(3):323-7. · 2.08 Impact Factor
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Blood 02/2002; 99(1):390-1. · 9.90 Impact Factor
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ABSTRACT: PURPOSEThe purposes of this study are to report experience with transjugular liver biopsy (TJLB) in patients with hematologic malignancy and severe thrombocytopenia and to determine the incidence of hemorrhage-related complications in patients with prebiopsy and pretransfusion platelet counts of 30 × 109/L or lower to propose a threshold platelet count above which TJLB can be safely performed without transfusion.MATERIALS AND METHODSMedical records and laboratory reports of 50 patients with severe thrombocytopenia who had undergone 51 TJLB procedures and prebiopsy platelet transfusions between August 1999 and September 2001 were retrospectively reviewed. Biopsy success and procedural complications were recorded.RESULTSTJLB was technically successful in 49 of 51 procedures (96%). The mean prebiopsy, pretransfusion platelet count was 17 × 109/L (range, 3−30 × 109/L) and a mean of 11 U (range, 6−32 U) of platelets per patient were transfused. The overall mean postbiopsy platelet count was 38 × 109/L (range, 5−105 × 109/L), but it remained 30 × 109/L or lower in 24 TJLB procedures. No hemorrhage-related complications were encountered, but ventricular fibrillation occurred in one patient during the procedure.CONCLUSIONA threshold platelet count for safe TJLB resides below 30 × 109/L. A prospective study is necessary to better define a lower threshold above which TJLB can be performed without platelet transfusion.
Journal of Vascular and Interventional Radiology.
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