RESUMO
BACKGROUND AND OBJECTIVES: Calculation of blood volume (BV) to be processed to achieve the target number of CD34+ cells can be accomplished by using collection efficiency 2 (CE2) formula. Our aim was to develop a BV web formula. MATERIALS AND METHODS: We calculated CE2 from aphereses performed between January 2015 and March 2020 in allogeneic donors and patients. From May 2020 to May 2021, we validated a formula: BV = ((Target CD34+ cells in the product)/(CD34+ pre-apheresis cells × CE2)) × 100. Subsequently, we compared the outcome of the procedures carried out before formula implementation (pre-formula), when standard three total BV collection was performed. RESULTS: CE2 was assessed in 384 apheresis procedures before formula implementation. CE2 was higher in allogeneic donors than in patients (53% ± 17% vs. 48% ± 15%, p = 0.008). CE2 was higher in multiple myeloma and non-Hodgkin lymphoma than Hodgkin's lymphoma (48% ± 15%, 48% ± 15% and 42% ± 13%, respectively; p = 0.008). Our formula (available on a website: Publisheet) was prospectively used in 54 individuals. The formula was very accurate: predicted versus observed CD34 + cells/kg collected had an r-value of 0.89 (p < 0.0001). We compared their results with 78 pre-formula individuals. In the post-formula group, a greater BV was processed in patients and less BV in allogeneic donors. Among individuals under 60 years of age, it was significantly less frequent than the need for more than one apheresis in the post-formula group. CONCLUSION: Formula calculations were accurate. Formula implementation allowed the optimization of the procedures and reduced the rate of individuals in need of apheresis for more than 1 day.
Assuntos
Remoção de Componentes Sanguíneos , Mieloma Múltiplo , Humanos , Remoção de Componentes Sanguíneos/métodos , Antígenos CD34 , Doadores de Tecidos , Volume Sanguíneo , Mobilização de Células-Tronco Hematopoéticas/métodosAssuntos
Adenina/análogos & derivados , Hemorragias Intracranianas/complicações , Leucemia Linfocítica Crônica de Células B/complicações , Leucemia Linfocítica Crônica de Células B/tratamento farmacológico , Piperidinas/uso terapêutico , Inibidores de Proteínas Quinases/uso terapêutico , Adenina/uso terapêutico , Idoso , Encéfalo/efeitos dos fármacos , Encéfalo/patologia , Humanos , Hemorragias Intracranianas/diagnóstico , Leucemia Linfocítica Crônica de Células B/diagnóstico , MasculinoAssuntos
COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Leucemia Mieloide/terapia , SARS-CoV-2/isolamento & purificação , Doença Aguda , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , COVID-19/virologia , Estudos de Coortes , Feminino , Humanos , Estimativa de Kaplan-Meier , Leucemia Mieloide/diagnóstico , Masculino , Pessoa de Meia-Idade , Pandemias , SARS-CoV-2/fisiologia , EspanhaRESUMO
BACKGROUND: During the COVID-19 outbreak, most hospitals deferred elective surgical procedures to allow space for the overwhelming number of COVID-19 patient admissions, expecting a decrease in routine blood component requirements. However, because transfusion support needs of COVID-19 patients are not well known, its impact on hospital blood supply is uncertain. The objective of this study was to assess the effect of the COVID-19 pandemic on transfusion demand. STUDY DESIGN AND METHODS: Transfusion records during the peak of the COVID-19 pandemic (March 1-April 30, 2020) were reviewed in our center to assess changes in blood requirements. RESULTS: During this period 636 patients received a total of 2934 blood components, which reflects a 17.6% reduction in transfusion requirements with regard to the same period of 2019, and blood donations in Madrid dropped by 45%. The surgical blood demand decreased significantly during the outbreak (50.2%). Blood usage in the hematology and oncology departments remained unchanged, while the day ward demand halved, and intensive care unit transfusion needs increased by 116%. A total of 6.2% of all COVID inpatients required transfusion support. COVID-19 inpatients consumed 19% of all blood components, which counterbalanced the savings owed to the reduction in elective procedures. CONCLUSION: Although only a minority of COVID-19 inpatients required transfusion, the expected reduction in transfusion needs caused by the lack of elective surgical procedures is partially offset by the large number of admitted patients during the peak of the pandemic. This fact must be taken into account when planning hospital blood supply.
Assuntos
Transfusão de Sangue/métodos , COVID-19/terapia , SARS-CoV-2/patogenicidade , Idoso , Transfusão de Componentes Sanguíneos/métodos , Doadores de Sangue , COVID-19/virologia , Surtos de Doenças , Feminino , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , PandemiasAssuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Tratamento Farmacológico da COVID-19 , COVID-19 , Leucemia Mieloide Aguda , SARS-CoV-2 , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , COVID-19/mortalidade , Intervalo Livre de Doença , Feminino , Humanos , Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Mieloide Aguda/mortalidade , Masculino , Pessoa de Meia-Idade , Taxa de SobrevidaRESUMO
No disponible
Assuntos
Humanos , Masculino , Adulto , Perfuração Intestinal , Intestinos/lesões , Doença Celíaca , Linfoma Difuso de Grandes Células B/complicações , Neoplasias Intestinais , Intestinos/diagnóstico por imagem , Tomografia Computadorizada Espiral/métodosAssuntos
Doença Celíaca/complicações , Perfuração Intestinal/etiologia , Doenças do Jejuno/etiologia , Linfoma Difuso de Grandes Células B/complicações , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Doença Celíaca/dietoterapia , Colectomia , Terapia Combinada , Ciclofosfamida/administração & dosagem , Dieta Livre de Glúten , Suscetibilidade a Doenças , Síndrome de Down/complicações , Doxorrubicina/administração & dosagem , Humanos , Perfuração Intestinal/cirurgia , Doenças do Jejuno/cirurgia , Neoplasias do Jejuno/complicações , Neoplasias do Jejuno/tratamento farmacológico , Neoplasias do Jejuno/prevenção & controle , Neoplasias do Jejuno/cirurgia , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/prevenção & controle , Linfoma Difuso de Grandes Células B/cirurgia , Masculino , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Prednisona/administração & dosagem , Rituximab/administração & dosagem , Tomografia Computadorizada por Raios X , Vincristina/administração & dosagemRESUMO
BACKGROUND: Haemoglobinopathies have spread owing to human migration, and the number of people needing diagnosis and management of these conditions is increasing. Clinicians need to accurately identify carriers and provide adequate genetic counselling in order to prevent the occurrence of homozygous or compound heterozygous offspring. OBJECTIVES: To identify red blood cell (RBC) laboratory parameters that discriminate between structural haemoglobinopathy carriers and healthy subjects, and to compare RBC laboratory indices between HbAS and HbAC individuals. METHODS: Samples of 500 variant Hb carriers (355 HbAS, 104 HbAC, 19 HbAD, 7 HbAE, 7 HbAO-Arab, 4 α-chain variants and 4 Hb Lepore) and 251 normal controls were run on an Advia 2120 analyser (Siemens). Classic haematological parameters and RBC populations were assessed in all subjects. A multivariable binary logistic regression model was created to predict the probability of a subject carrying any structural haemoglobinopathy. HbAS (n=355, 71%) and HbAC (n=104, 20.8%) subjects were compared. RESULTS: A clinical prediction rule was developed by assigning one point to each of the most efficient variables: mean corpuscular volume (MCV) <88.4â fL, RBC distribution width >13.4%, percentage of microcytic RBCs (%MICRO) >0.7% and the ratio of microcytic RBCs to hypochromic RBCs >0.8. A score of 0, 1, 2, 3 or 4, resulted in a probability of 9.6%, 36.3%, 66.7%, 85.2% or 98.3%, respectively. Among the most frequent variant Hb, HbAC subjects had lower values of parameters related to cell size (MCV, %MICRO) and higher values of parameters related to haemoglobin concentration (MCHC, %HYPER) than HbAS subjects. Coexistence of α-thalassaemia in both HbAS and HbAC individuals resulted in decreased Hb, MCV, MCH and MCHC. CONCLUSIONS: Structural haemoglobinopathy should be investigated in subjects belonging to ethnic groups with high prevalence of variant Hb and with a score of 3 or 4. Erythrocytes of HbAC subjects are smaller and denser than those of HbAS subjects.