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platelet transfusion refractoriness

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https://www.readbyqxmd.com/read/29443045/routine-screening-method-for-microparticles-in-platelet-transfusions
#1
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
#2
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
#3
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)...
January 25, 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
#4
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
#5
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
#6
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
#7
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 la Tour
Few therapeutic options are available for aplastic anemia patients ineligible for transplantation or refractory to immunosuppressive therapy. Eltrombopag recently showed tri-lineage responses in refractory patients. However, real-life use of this drug remains unknown. This retrospective study (2012-2016) was conducted by the French Reference Center for Aplastic anemia on patients with relapse/refractory aplastic anemia, and patients ineligible for anti-thymocyte globulin (naive) or transplantation, who received eltrombopag for at least two months...
November 23, 2017: Haematologica
https://www.readbyqxmd.com/read/29150812/factors-influencing-platelet-transfusion-refractoriness-in-patients-undergoing-allogeneic-hematopoietic-stem-cell-transplantation
#8
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-consistent-low-hla-b8-b12-or-b35-expression-do-not-undergo-antibody-mediated-internalization
#9
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 due to 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 for 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...
November 1, 2017: 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
#10
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
https://www.readbyqxmd.com/read/29069007/successful-eltrombopag-treatment-of-severe-refractory-thrombocytopenia-in-chronic-myelomonocytic-leukemia-two-cases-reports-a-care-compliant-article
#11
Yayue Gao, Ming Gong, Chunxia Zhang, Xudong Kong, Yigai Ma
RATIONALE: Thrombocytopenia in chronic myelomonocytic leukemia (CMML) is usually attributed to impaired marrow production resulting from cytotoxic drug use or CMML itself ("CMML-induced thrombocytopenia"). In very rare cases, immune thrombocytopenia (ITP) can be a complication of CMML ("CMML-associated ITP"). However, treatment of severe thrombocytopenia in patients with CMML is still a challenge. PATIENT CONCERNS: Case 1 was a 61-year-old female patient admitted to our hospital because of skin petechiae and purpura for 6 days...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29054515/blood-transfusion-management-and-transfusion-related-outcomes-in-daratumumab-treated-patients-with-relapsed-or-refractory-multiple-myeloma
#12
Ajai Chari, Suzanne Arinsburg, Sundar Jagannath, Toshihisa Satta, Ivey Treadwell, Donna Catamero, Gillian Morgan, Huaibao Feng, Clarissa Uhlar, Imran Khan, Parul Doshi, Saad Usmani
INTRODUCTION: Daratumumab, a human CD38 monoclonal antibody approved for multiple myeloma (MM) treatment, binds red blood cells (RBCs), resulting in panagglutination in compatibility tests. Published mitigation methods avoid additional testing, ensuring timely release of blood products. Blood transfusion management and transfusion-related outcomes of daratumumab-treated patients in the SIRIUS study are reported, with emphasis on 2 clinical sites. PATIENTS AND METHODS: Patients had MM treated with ≥ 3 prior lines of therapy, including a proteasome inhibitor and an immunomodulatory drug, or were refractory to a proteasome inhibitor and an immunomodulatory drug...
September 19, 2017: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/29051993/treatment-related-sinusoidal-obstruction-syndrome-in-children-with-de-novo-acute-lymphoblastic-leukemia-during-intensification
#13
Casey L McAtee, Netta Schneller, Julienne Brackett, M Brooke Bernhardt, Eric S Schafer
PURPOSE: Sinusoidal obstruction syndrome (SOS), also known as veno-occlusive disease, has been described following treatment of acute lymphoblastic leukemia (ALL) with the anti-metabolite 6-thioguanine (6-TG). Previous studies incorporating daily 6-TG into maintenance chemotherapy demonstrated a high incidence of SOS, typically presenting after prolonged exposures to 6-TG. 6-TG continues to be used as a single, 14-day burst during intensification; however, SOS associated with brief courses of 6-TG is poorly described...
October 19, 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28982668/induced-pluripotent-stem-cell-derived-megakaryocytes-and-platelets-for-disease-modeling-and-future-clinical-applications
#14
REVIEW
Sara Borst, Xiuli Sim, Mortimer Poncz, Deborah L French, Paul Gadue
Platelets, derived from megakaryocytes, are anucleate cytoplasmic discs that circulate in the blood stream and play major roles in hemostasis, inflammation, and vascular biology. Platelet transfusions are used in a variety of medical settings to prevent life-threatening thrombocytopenia because of cancer therapy, other causes of acquired or inherited thrombocytopenia, and trauma. Currently, platelets used for transfusion purposes are donor derived. However, there is a drive to generate nondonor sources of platelets to help supplement donor-derived platelets...
November 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28979628/determination-in-vivo-viability-of-a-transfused-platelet-product-by-corrected-count-increment-and-percentage-platelet-response
#15
Nancy Wanjiru Thuku, Kibet Shikuku, Amos Mbugua
INTRODUCTION: For many years, platelet concentrates have been used for the prevention as well as treatment of bleeding disorders, especially in those patients with haematological problems involving platelet disorders as well as refractoriness, In addition, platelet concentrates (PCs) have been widely used to support patients undergoing bone marrow transplantation or who are receiving myelotoxic treatments. The aim of this study was to determine the quality of platelet concentrates by assessing platelet counts, volume, pH changes, swirling, residue of the red blood cells and white blood cell counts...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28970690/successful-surgical-procedure-in-a-patient-of-aplastic-anemia-with-platelet-refractoriness-using-cross-match-compatible-platelets
#16
Ritam Chakrabarty, Sudipta Sekhar Das
This case marks the beginning of issuing cross-matched platelet products in Eastern India. A known case of aplastic anemia, on regular transfusion support, now presented with obstructed ventral periumbilical hernia requiring urgent surgical intervention. Platelet count at presentation was 13,000/μL. Platelet cross-matching was done by solid phase method. Ten units of random donor platelets were crossmatched. Five units were compatible and transfused. Counts rose to 84,000/μL after 1 h. Surgery was completed successfully...
July 2017: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/28970003/identification-of-underlying-and-transfusion-related-platelet-qualitative-alterations-in-the-hemato-oncologic-patient
#17
REVIEW
Carmen Vicente-Ayuso, Petros Papadopoulos, María Villa-Fajardo, Blanca Prieto, Ana María Álvarez-Carmona, Marta Mateo-Morales, Cristina Pérez-López, Ascensión Peña-Cortijo, Marta Polo-Zarzuela, Isabel Sáez, María Paz Martín, Celina Benavente-Cuesta, Ataúlfo González-Fernández, Rafael Martínez-Martínez, Jaap Jan Zwaginga, Jerard Seghatchian, Laura Gutiérrez
Hemato-oncologic patients with chemotherapy-induced thrombocytopenia are one of the populations receiving platelet transfusions. The general practice with these patients is to give prophylactic platelet transfusions when platelet counts fall below 10×109PLT/L. However, in more than 40% of these patients, platelet transfusion does not prevent bleeding. The reason of the low efficacy of platelet transfusion in the context of chemotherapy patients is not entirely understood. We therefore aimed at immunophenotyping the expression of platelet surface and activation markers and thrombopoietin levels from hemato-oncologic patients before and after transfusion...
October 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28967418/recombinant-factor-viia-use-in-acute-type-a-aortic-dissection-repair-a-multicenter-propensity-score-matched-report-from-the-nordic-consortium-for-acute-type-a-aortic-dissection
#18
Igor Zindovic, Johan Sjögren, Anders Ahlsson, Henrik Bjursten, Simon Fuglsang, Arnar Geirsson, Richard Ingemansson, Emma C Hansson, Ari Mennander, Christian Olsson, Emily Pan, Susann Ullén, Tomas Gudbjartsson, Shahab Nozohoor
BACKGROUND: Surgery for acute type A aortic dissection (ATAAD) is often complicated by excessive bleeding. Recombinant factor VIIa (rFVIIa) effectively treats refractory bleeding associated with ATAAD surgery; however, adverse effects of rFVIIa in these patients have not been fully assessed. Here we evaluated rFVIIa treatment in ATAAD surgery using the Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD) database. METHODS: This was a multicenter, propensity score-matched, retrospective study...
August 24, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28960321/how-do-i-%C3%A2-manage-the-platelet-transfusion-refractory-patient
#19
Justin E Juskewitch, Andrew P Norgan, Steven R De Goey, Patti M Duellman, Laurie L Wakefield, Manish J Gandhi, James R Stubbs, Justin D Kreuter
BACKGROUND: Platelet transfusion-refractoriness is a challenging and expensive clinical scenario seen most often in patients with hematologic malignancies. Although the majority of platelet transfusion-refractory cases are due to nonimmune causes, a significant minority are caused by alloimmunization against Class I human leukocyte antigens (HLAs) or human platelet antigens (HPAs). Such platelet transfusion-refractory patients can be effectively managed with appropriate antigen-negative products...
September 28, 2017: Transfusion
https://www.readbyqxmd.com/read/28947425/treatment-of-immune-thrombocytopenic-purpura-associated-with-cytomegalovirus-infection-in-a-child-with-pre-b-cell-acute-lymphoblastic-leukaemia-after-central-nervous-system-relapse
#20
Ashley R Martinez, Megan Rose Paul, Dennis John Kuo
A 13-year-old male patient with a history of pre-B cell acute lymphoblastic leukaemia (ALL) with isolated central nervous system relapse on maintenance chemotherapy presented with severe thrombocytopenia refractory to platelet transfusions. The patient showed only modest responses to two courses of intravenous immunoglobulin and steroids. He was found to be positive for cytomegalovirus (CMV) with modest viral load. His thrombocytopenia normalised with rituximab therapy and CMV treatment supporting the diagnosis of CMV-associated immune thrombocytopenic purpura (ITP)...
September 25, 2017: BMJ Case Reports
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