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platelet transfusion refractoriness

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https://www.readbyqxmd.com/read/29691259/transdermal-estradiol-for-the-management-of-refractory-uremic-bleeding
#1
Jimmy Gonzalez, Samantha Bryant, Evelyn R Hermes-DeSantis
PURPOSE: The efficacy and thrombogenicity of transdermal estradiol in the management of refractory uremic bleeding in adults are examined. SUMMARY: Platelet dysfunction from chronic kidney disease may induce uremic bleeding. This type of bleeding may involve the skin, oral and nasal mucosa, gingivae, respiratory system, and gastrointestinal or urinary tract. While the mainstay of treatment for uremic bleeding primarily involves dialysis and use of prohemostatic agents such as desmopressin and erythropoiesis-stimulating agents, certain patients may experience bleeding refractory to these interventions...
May 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29683946/romiplostim-for-immune-thrombocytopenia-in-neuroblastoma-patients-receiving-chemotherapy
#2
Hannah Fassel, James B Bussel, Stephen S Roberts, Shakeel Modak
Thrombocytopenia, a serious complication of myelosuppressive chemotherapy in cancer patients, is managed with platelet transfusions until recovery of platelet counts. However, children receiving chemotherapy can rarely develop immune thrombocytopenia (ITP) that is refractory to transfused platelets. This limits the ability to achieve adequate platelet counts and administer further myelosuppressive chemotherapy safely, especially if first-line ITP therapy is ineffective. We report 2 cases of intravenous immunoglobulin refractory ITP in children receiving chemotherapy for high-risk neuroblastoma...
April 20, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29665929/-anti-cd36-mediated-platelet-transfusion-refractoriness-and-related-cases-after-stem-cell-transplantation
#3
Yan Zhou, Li-Lan Li, Zhou-Lin Zhong, Xue-Jun Liu, Jin-Lian Liu, Wei-Dong Shen, Guo-Guang Wu
OBJECTIVE: To analyse the cases of platelet transfusion refractoriness after received HLA-matched unrelated donor hematopoietic stem cell transplantation, to analyze and identify the phenotype and genotype of CD36 in both the patient and stem cell donor, as well as the characteristic of antibody induced platelet transfusion refractoriness, and to analyse the efficacy of matched CD36-deficiency platelets transfusions. METHODS: The CD36 expression on platelet and monocyte was analyzed by flow cytometry (FCM) in both patient and donor...
April 2018: Zhongguo Shi Yan Xue Ye Xue za Zhi
https://www.readbyqxmd.com/read/29664113/peripartum-management-of-hla-alloimmune-platelet-refractoriness
#4
Jeremy Ryan Peña, Leanna Sudhof, Barbara O'Brien
BACKGROUND: Platelet (PLT) refractoriness presents a challenging problem for transfusion support, especially in the perioperative setting, where there is urgency for human leukocyte antigen (HLA)-compatible units, yet identification and provision of compatible PLT concentrates requires time. CASE REPORT: A 22-year-old G3P1 woman with thrombocytopenia due to aplastic anemia, likely autoimmune, presented in her third trimester for peripartum care and newly diagnosed HLA alloimmune PLT refractoriness...
April 17, 2018: Transfusion
https://www.readbyqxmd.com/read/29611179/anti-%C3%AE-iib-%C3%AE-3-immunization-in-glanzmann-thrombasthenia-review-of-literature-and-treatment-recommendations
#5
REVIEW
Mathieu Fiore, Roseline d'Oiron, Xavier Pillois, Marie-Christine Alessi
Glanzmann thrombasthenia (GT) is caused by inherited defects of the αII b β3 platelet glycoprotein. This bleeding disorder can be treated with platelet transfusion therapy, but some patients will be immunized and begin to form anti-human leucocyte antigen (HLA) and/or anti-αII b β3 antibodies. These antibodies can bind and interfere with the function of the transfused platelets, rendering treatment ineffective. However, platelet transfusion refractoriness attributable to HLA antibodies may be managed by the selection of compatible donors, although they are not always readily available, particularly in an emergency...
April 2, 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29532554/management-of-patients-with-severe-epstein-syndrome-a-review-of-four-patients-who-received-living-donor-renal-transplantation
#6
Junya Hashimoto, Yuko Hamasaki, Yusuke Takahashi, Mai Kubota, Taketo Yanagisawa, Yoshihiro Itabashi, Masaki Muramatsu, Takeshi Kawamura, Naonori Kumagai, Yoko Ohwada, Ken Sakai, Seiichiro Shishido
AIM: Epstein syndrome is a hereditary disease characterised by macrothrombocytopaenia and progressive nephritis. The abnormality of the MYH9 gene has a strong relationship to the severity of the disease. Severe Epstein syndrome progresses to end-stage renal disease rapidly after adolescence. There is no established therapy. We sought to clarify appropriate management of Epstein syndrome nephropathy. METHODS: Epstein syndrome patients who underwent renal transplantation at our institution between March 2009 and March 2017 were enrolled...
March 13, 2018: Nephrology
https://www.readbyqxmd.com/read/29514403/mechanical-circulatory-support-for-acute-right-ventricular-failure-in-the-setting-of-pulmonary-embolism
#7
Mahir Elder, Nimrod Blank, Amir Kaki, M Chadi Alraies, Cindy L Grines, Marvin Kajy, Reema Hasan, Tamam Mohamad, Theodore Schreiber
BACKGROUND: Right ventricular (RV) failure due to pulmonary embolism (PE) increases morbidity and mortality and contributes to prolonged hospital length of stay and higher costs of care. RV mechanical circulatory support (MCS) including Impella RP devices have been increasingly used in hemodynamically compromised PE patients who are refractory to intravascular volume expansion and inotropic therapy. However, effectiveness and safety of Impella RP, in hemodynamically unstable PE patients is unknown...
March 7, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29500545/effect-of-qinghuang-powder-combined-with-bupi-yishen-decoction-in-treating-patients-with-refractory-cytopenia-with-multilineage-dysplasia-through-regulating-dna-methylation
#8
Qing-Bing Zhou, Xiao-Hong Yang, Hong-Zhi Wang, De-Xiu Wang, Yong-Gang Xu, Xiao-Mei Hu, Feng-Qin Xu, Rou Ma
OBJECTIVE: To explore the effect of Qinghuang Powder (QHP, ) combined with Bupi Yishen Decoction (BPYS, ) on myelodysplastic syndromes (MDS) patients with refractory cytopenia with multilineage dysplasia (RCMD) and determine the change of DNA methylation in MDS-RCMD patients after the treatment of Chinese medicine formula. METHODS: All 308 MDS-RCMD patients were treated with QHP combined with BPYS for 2 months at least, absolute neutrophil count (ANC), hemoglobin (Hb), platelets (PLT), primitive bone marrow cells and chromosome karyotype were chosen as the main evaluation indexes to analyze the treatment effect according to criteria from the MDS International Working Group...
March 2, 2018: Chinese Journal of Integrative Medicine
https://www.readbyqxmd.com/read/29478960/platelet-component-transfusion-and-alloimmunization-where-do-we-stand
#9
P Moncharmont
Platelet transfusion in patients, particularly in onco-haematology, is frequent and can become chronic in some cases. Post-transfusion alloimmunization is often seen, in practice. The risk of this is significantly improved in multitransfused patients. Several classes of antigens binding on platelets (HLA and HPA) are involved and also red blood cell antigens (residual red blood cells in platelet concentrates). Platelet alloimmunization causes a poor transfusion response, refractoriness and, more rarely, post-transfusion purpura...
February 22, 2018: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/29460307/antibodies-to-human-platelet-antigens-form-a-significant-proportion-of-platelet-antibodies-detected-in-indian-patients-with-refractoriness-to-platelet-transfusions
#10
A S Abraham, M P Chacko, N A Fouzia, A Srivastava, D Daniel
BACKGROUND: The transfusion of platelets is an important therapeutic strategy in bleeding patients with thrombocytopenia. However, some chronically transfused patients fail to achieve the appropriate platelet count increment following transfusion due to the presence of platelet alloantibodies. OBJECTIVES: The aims of this research were to study the prevalence of platelet alloimmunisation and to characterise the platelet-reactive (PR) antibodies in haematology patients refractory to platelet transfusions in an Indian setting...
February 19, 2018: Transfusion Medicine
https://www.readbyqxmd.com/read/29443045/routine-screening-method-for-microparticles-in-platelet-transfusions
#11
Daniel Millar, Larry Murphy, Audrey Labrie, Elisabeth Maurer-Spurej
Platelet inventory management based on screening microparticle content in platelet concentrates is a new quality improvement initiative for hospital blood banks. Cells fragment off microparticles (MP) when they are stressed. Blood and blood components may contain cellular fragments from a variety of cells, most notably from activated platelets. When performing their roles as innate immune cells and major players in coagulation and hemostasis, platelets change shape and generate microparticles. With dynamic light scattering (DLS)-based microparticle detection, it is possible to differentiate activated (high microparticle) from non-activated (low microparticle) platelets in transfusions, and optimize the use of this scarce blood product...
January 31, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29410296/low-cd34-cell-doses-are-associated-with-increased-cost-and-worse-outcome-following-of-tandem-autologous-stem-cell-transplantation-in-patients-with-relapsed-or-refractory-germ-cell-tumors
#12
Mustafa A Hyder, W Scott Goebel, Kirsten D Ervin, Jennifer E Schwartz, Michael J Robertson, Teresa C Thakrar, Costantine Albany, Sherif S Farag
Tandem autologous stem cell transplantation (ASCT) improves long-term survival of platinum-refractory germ cell tumors (GCT) patients. Studies, predominantly in lymphoma, showed that CD34+ cell doses > 5.0 x 106/kg/single transplant lead to decreased resource utilization. As most GCT patients have received prior cisplatin-based treatment, collecting >10x106 CD34+ cells/kg is challenging. We analyzed the effect of CD34+ cell dose on resource utilization and outcome of in 131 GCT patients, median age 29...
February 2, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29372241/pathogen-reduced-platelets-for-the-prevention-of-bleeding-in-people-of-any-age
#13
Lise J Estcourt, Reem Malouf, Michael F Murphy
Clinical Question: Are pathogen-reduced platelets as effective as standard platelets for the prevention of bleeding in people of any age requiring platelet transfusions? Bottom Line: In people with cancer who have a low platelet count due to their disease or its treatment, pathogen-reduced platelet transfusions increase risk of platelet refractoriness and platelet transfusion requirement (high-quality evidence) but probably do not effect all-cause mortality, risk of clinically significant or severe bleeding, or risk of a serious adverse event (moderate-quality evidence)...
April 1, 2018: JAMA Oncology
https://www.readbyqxmd.com/read/29249783/-utility-of-partial-splenic-embolization-prior-to-lung-resection-in-patients-demonstrating-platelet-transfusion-refractoriness-due-to-hypersplenism
#14
Yusuke Tanaka, Isao Matsumoto, Daisuke Saito, Syuhei Yoshida, Seiichi Kakegawa, Masaya Tamura, Hirofumi Takemura
It is often difficult to control perioperative bleeding in patients with liver cirrhosis and concurrent thrombocytopenia and coagulation factor deficiency. Partial splenic embolization (PSE), an auxiliary treatment strategy in management of liver cirrhosis and hepatocellular carcinoma, can not only increase platelets but also improve liver function. With advances in interventional radiology, PSE is a safer and more reliable procedure compared to a splenectomy. We present the case of a 69-year-old man diagnosed with left lung cancer, with thrombocytopenia, and hepatitis C virus-related cirrhosis...
December 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29188582/a-low-birth-weight-infant-with-no-malformations-delivered-by-a-primary-immune-thrombocytopenia-patient-treated-with-eltrombopag
#15
Naruko Suzuki, Junji Hiraga, Yumi Hariyama, Yusuke Takagi, Haruhiko Ohashi, Yasuyuki Kishigami, Hidenori Oguchi, Yoshitoyo Kagami
Primary immune thrombocytopenia (ITP) is defined by a low platelet count secondary to antibody-mediated platelet destruction or reductions in platelet production. Although eltrombopag is a thrombopoietin receptor agonist that increases platelet production in refractory or relapsed ITP, the influence on pregnancy is limited. We present the case of a pregnant 25-year-old ITP patient referred to our hospital with a history of two induced abortions. After eradication of Helicobacter pylori and with oral prednisolone at 8 mg/day, platelet count remained below 10,000/µl...
November 29, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/29182495/platelet-transfusion-for-patients-with-cancer-american-society-of-clinical-oncology-clinical-practice-guideline-update
#16
Charles A Schiffer, Kari Bohlke, Meghan Delaney, Heather Hume, Anthony J Magdalinski, Jeffrey J McCullough, James L Omel, John M Rainey, Paolo Rebulla, Scott D Rowley, Michael B Troner, Kenneth C Anderson
Purpose To provide evidence-based guidance on the use of platelet transfusion in people with cancer. This guideline updates and replaces the previous ASCO platelet transfusion guideline published initially in 2001. Methods ASCO convened an Expert Panel and conducted a systematic review of the medical literature published from September 1, 2014, through October 26, 2016. This review builds on two 2015 systematic reviews that were conducted by the AABB and the International Collaboration for Transfusion Medicine Guidelines...
January 20, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29170252/nationwide-survey-on-the-use-of-eltrombopag-in-patients-with-severe-aplastic-anemia-a-report-on-behalf-of-the-french-reference-center-for-aplastic-anemia
#17
Etienne Lengline, Bernard Drenou, Pierre Peterlin, Olivier Tournilhac, Julie Abraham, Ana Berceanu, Brigitte Dupriez, Gaelle Guillerm, Emmanuel Raffoux, Flore Sicre de Fontbrune, Lionel Ades, Marie Balsat, Driss Chaoui, Paul Coppo, Selim Corm, Thierry Leblanc, Natacha Maillard, Louis Terriou, Gerard Socié, Regis Peffault de Latour
Few therapeutic options are available for patients with aplastic anemia who are ineligible for transplantation or refractory to immunosuppressive therapy. Eltrombopag was recently shown to produce trilineage responses in refractory patients. However, the effects of real-life use of this drug remain unknown. This retrospective study (2012-2016) was conducted by the French Reference Center for Aplastic Anemia on patients with relapsed/refractory aplastic anemia, and patients ineligible for antithymocyte globulin or transplantation, who received eltrombopag for at least 2 months...
February 2018: Haematologica
https://www.readbyqxmd.com/read/29150812/factors-influencing-platelet-transfusion-refractoriness-in-patients-undergoing-allogeneic-hematopoietic-stem-cell-transplantation
#18
Pilar Solves, Jaime Sanz, Carmen Freiria, Marta Santiago, Ana Villalba, Inés Gómez, Pau Montesinos, Juan Montoro, Jose Luis Piñana, José Ignacio Lorenzo, Nieves Puig, Guillermo F Sanz, Miguel Ángel Sanz, Nelly Carpio
Hematopoietic stem cell transplantation has been considered a risk factor for development of platelet transfusion refractoriness. The objective of this study was to assess the platelet transfusion refractoriness rate in patients undergoing allogeneic hematopoietic stem cell transplantation from different sources. We retrospectively reviewed the charts and transfusion records of patients who underwent allogeneic stem cell transplantation at our institution between 2013 and 2015. The evaluation of post-transfusion platelet count was assessed for each transfusion given, from day of progenitor infusion to day 30 after transplantation...
January 2018: Annals of Hematology
https://www.readbyqxmd.com/read/29092829/platelets-from-donors-with-consistently-low-hla-b8-b12-or-b35-expression-do-not-undergo-antibody-mediated-internalization
#19
Anno Saris, Bert Tomson, Anneke Brand, Arend Mulder, Frans H Claas, Jos Lorinser, John Scharenberg, S Marieke van Ham, Anja Ten Brinke, Jaap Jan Zwaginga, Pieter F van der Meer
Patients refractory to platelet transfusions because of alloimmunization require HLA-matched platelets, which is only possible if a large HLA-typed donor pool is available. However, even then, patients with broad immunization or rare haplotypes may not have suitable donors. In these patients, transfusions with platelets showing low HLA class I expression may be an alternative to fully HLA-matched transfusions. In this study, we quantified the proportion of donors with consistently low HLA-B8, -B12, and -B35 expression on platelets using human monoclonal antibodies specific for these antigens...
January 4, 2018: Blood
https://www.readbyqxmd.com/read/29080548/efficacy-of-recombinant-factor-viia-for-severe-bleeding-complicated-by-platelet-transfusion-refractoriness-in-patients-with-hematologic-malignancies
#20
Tiantian Chu, Yaqiong Tang, Hong Wang, Jiaqian Qi, Ying Zhao, Tingting Pan, Xiaowen Tang, Huiying Qiu, Chengcheng Fu, Changgeng Ruan, De-Pei Wu, Yue Han
INTRODUCTION: Severe bleeding with platelet transfusion refractoriness (PTR) is a common complication associated with reduced survival in patients with hematologic malignancies. The present study aimed to evaluate the efficacy of recombinant factor VIIa (rFVIIa) for severe bleeding complicated by PTR. MATERIALS AND METHODS: Sixty-four patients suffering from severe bleeding with PTR hospitalized in our center between September 2012 and December 2016 were enrolled in this study...
December 2017: Thrombosis Research
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