Analysis of Current Status of Chronic Red Blood Cell Transfusion / 대한수혈학회지

BACKGROUND: Chronic red blood cell (RBC) transfusion is widely practiced as part of supportive care in patients with chronic anemia. However, there were few reports on the actual situation in Korea. Therefore, we studied the current status of chronic RBC transfusion. METHODS: Among patients who received RBC transfusions at a regional hospital from January 2011 to December 2015, patients who were consistently transfused with more than 15 units of RBC for more than one year were included. We retrospectively analyzed the status of RBC transfusion, including the laboratory findings related to transfusion using medical records. RESULTS: A total of 58 patients were included in the study. The mean age of patients was 66.4 years, and there were 24 hematologic malignancies (41.4%), 20 malignant tumors (34.5%), and 14 chronic diseases (24.1%). The mean hemoglobin level at the beginning of transfusion was 7.0 g/dL, and eight patients (13.8%) showed RBC alloimmunization as the transfusion proceeded. The mean serum ferritin level at the initial phase of transfusion was 475.3 ng/mL and increased to 1,462 ng/mL during the late phase of transfusion. CONCLUSION: Since the number of elderly patients treated with chronic diseases including tumors is expected to increase significantly, patients with chronic transfusions are also expected to increase. It is necessary to research and prepare measures such as establishment of guidelines.

Dosis moderadas de hidroxiurea en niños con drepanocitosis y accidente vascular encefálico. Resultados preliminares / Moderate dose of hydroxyurea in children with sickle cell disease and stroke. Preliminary results

Se trataron 20 niños con anemia drepanocítica, dos ellos con hemoglobinopatía SC y uno con S/â0 talasemia con accidente vascular encefálico o Doppler transcraneal con velocidades del flujo sanguíneo mayor de 170 cm/s. La media de seguimiento fue de 41 ± 19 meses. En los pacientes con accidente vascular encefálico se administraron 25 mg/kg/día de hidroxiurea y se realizó régimen de transfusión crónica por un año. En los niños con Doppler transcraneal patológico se administró la hidroxiurea sola en igual dosis. Hubo una disminución significativa del número de accidentes vasculares encefálicos (p <0.02) y de la velocidad del flujo sanguíneo en la arteria cerebral media derecha (p <0.003). En tres niños con velocidades de flujo muy aumentadas en el Doppler transcraneal sin accidente vascular encefálico fue necesario asociar régimen de hipertransfusión por no respuesta al tratamiento. La asociación de hidroxiurea y transfusiones de glóbulos rojos durante un año pueden ser útiles en el tratamiento y prevención del accidente vascular encefálico

Twenty children with sickle cell anemia, two with SC hemoglobinopathy and one with S/â0 thalassemia were treated, with a previous stroke or abnormal ultrasound transcranial Doppler (TCD) flow velocities more than 170 cm/s. The mean follow-up was of 41 ± 19 months. Hydroxyurea (HU) at a dose of 25 mg/kg/day associated with chronic transfusion therapy, was administrated during one year to patients with stroke. Patients with abnormal TCD received only HU at the same dose. There was a significant decrease of stroke (p <0.02) and TCD flow velocities in the right middle cerebral artery (p <0.003). It was necessary to associate chronic transfusion therapy in three children with high velocities in TCD without stroke, due to the lack of response to the treatment with HU. The combination of HU and transfusions during one year can be useful for stroke therapy and prevention