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Impact of pretransplant CONUT score on posttransplant engraftment kinetics and overall survival in patients with multiple myeloma.

BACKGROUND: Nutritional status has increasingly been recognized as an important determinant of clinical outcomes in patients with hematologic malignancies. The Controlling Nutritional Status (CONUT) score, which integrates serum albumin, total cholesterol, and lymphocyte count, provides an objective assessment of both nutritional and immunological status. However, the impact of pretransplant CONUT score on hematopoietic engraftment kinetics and clinical outcomes in multiple myeloma patients undergoing autologous stem cell transplantation (ASCT) remains insufficiently characterized. METHODS: T

Middle meningeal artery embolization for symptomatic chronic subdural hematoma in the setting of severe transfusion-refractory thrombocytopenia: A case study and review of literature.

BACKGROUND: Surgical decompression for the treatment of chronic subdural hematomas (cSDHs) is irrefutably effective; however, its utility in managing cSDH in patients with comorbid coagulopathy remains controversial. The optimal threshold for platelet transfusion in cSDH management is <100,000/mm3, according to guidelines from the American Association of Blood Banks GRADE framework. This threshold may be unachievable in refractory thrombocytopenia, though surgical intervention may still be warranted. We present a patient with symptomatic cSDH and transfusion-refractory thrombocytopenia success…

Platelet Inhibitors.

Antithrombotic medications have become standard of care for management of acute coronary syndrome. Platelet adhesion, activation, and aggregation are essential components of platelet function; platelet-inhibiting medications interfere with these components and reduce incidence of thrombosis. Active bleeding is a contraindication for administration of platelet inhibitors. There is currently no reversal agent for platelet inhibitors, although platelet transfusion may be used to correct active bleeding after administration of platelet inhibitors.

The Utility of Viscoelastic Testing in Guiding Intraoperative Transfusion Requirements in Pediatric Living Donor Liver Transplantation.

INTRODUCTION: Blood transfusion, though essential, is associated with increased morbidity following liver transplantation (LT). In pediatric liver transplantation (PLT), where physiological reserves are limited, optimal blood component transfusion (BCT) is critical. While viscoelastic testing (VET) has shown benefits in adult LT, pediatric evidence remains limited and transfusion triggers are poorly defined. This study evaluated the effectiveness of VET-guided BCT in pediatric living donor liver transplantation (LDLT). MATERIALS AND METHODS: A prospective analysis was conducted on children un

[Cardiac surgery in an octogenarian with idiopathic thrombocytopenic purpura: report of a case].

An 81-year-old woman was referred to our hospital for surgical treatment for mitral valve regurgitation, tricuspid valve regurgitation and a … failure, we underwent cardiac operation under thrombocytopenic condition. Intra and post-operative platelet transfusion might contribute to postoperative course uneventful without bleeding tendency. In this case, high-dose immunoglobulin therapy was not effective. However the operative course was satisfactory with adequate surgical hemostasis and platelet transfusion …

HLA-Mediated Platelet Refractoriness.

OBJECTIVES: To provide an overview of the complexities associated with the human leukocyte antigen (HLA)-mediated platelet refractoriness. HLA antibody detection technologies and limitations associated with methodologies are discussed. METHODS: A case scenario and review of relevant literature describing platelet refractoriness are presented, followed by a discussion of HLA antibody testing. RESULTS: Following diagnosis of HLA-mediated refractoriness, a decision is made regarding the approach to obtain the appropriate platelets. The panel reactive antibodies (PRA) % of the patient, HLA typin

Advancement of platelet-inspired nanomedicine.

Human platelets play important roles in several physiologic and pathologic processes. Any defects in platelet number and function can lead to a variety of bleeding complications; platelet transfusions are commonly used to improve platelet count and hemostatic function in these cases. However, transfusions are complicated by the short storage life of donated platelets and contamination risks. Synthetic platelet substitutes can render efficient hemostasis while allowing advantages of large-scale preparation, minimum contamination risk via effective sterilization, longer shelf-life, no need for b…

Post Splenectomy Outcome in β-Thalassemia.

OBJECTIVES: To evaluate changes in annual blood transfusion requirements and complications after splenectomy in patients with β-thalassemia. METHODS: Forty post-splenectomy β-thalassemic patients aged 8-33 y, receiving regular blood transfusions and chelation therapy were included and non transfusion dependant patients were excluded from this retrospective cross-sectional study. Details about their surgery, transfusion requirements, and platelet levels were recorded on a standard proforma. All patients underwent a B-mode and color-coded duplex sonography of the hepatoportal system during the

Pre-CAR-HEMATOTOX at Leukapheresis Predicts Delayed Platelet Recovery After Idecabtagene Vicleucel in Multiple Myeloma.

BACKGROUND: The CAR-HEMATOTOX score has been associated with hematologic toxicity after chimeric antigen receptor T-cell therapy, but it is … er 2022 and March 2026. The primary endpoint was time to platelet recovery to ≥ 100 × 109/L without platelet transfusion or thrombopoietin receptor agonist support. Secondary endpoints included time to platelet recovery to ≥ 75 × 109/L, time to neutrophil recovery to ≥ 1.0 × 109/L without granulocyte colony-stimulating factor support, and platelet transfusion burden. …

Feasibility and Safety of Home Blood Transfusion for Children With Advanced Stage Cancer: Experiences From a Single Institute.

Palliative home care for pediatric cancer patients has become increasingly common in Japan. Between April 2018 and July 2024, the Tokiwa Group provided home-based palliative care to 39 patients with advanced pediatric cancer. Among these, 16 patients received red blood cell and platelet transfusions, totaling 281 transfusions. A retrospective analysis revealed that blood and platelet transfusions can be performed at home as safely as in hospitals, with similarly low (2.1%) rates of adverse events. Increased use of home-based blood transfusions may further enhance quality of life for children w…

Clinical and economic impacts of large volume delayed sampling and pathogen reduction technology platelet processing strategies in the United States.

BACKGROUND: Large volume delayed sampling (LVDS) and pathogen reduction technology (PRT) are strategies for platelet processing to minimize transfusion of contaminated platelet components (PCs). This study holistically compares the economic and clinical impact of LVDS and PRT in the United States. STUDY DESIGN AND METHODS: A decision model was constructed to simulate collection, processing, and use of PCs and to compare processing strategies: PRT with 5-day shelf life, LVDS with 7-day shelf life (LVDS7), and LVDS with 5-day shelf life extended to 7 days with secondary testing (LVDS5/2). Targe

A practical concept for preoperative management of patients with impaired primary hemostasis.

In a prospective study, 254 of 5649 unselected patients scheduled for surgery at our hospital were identified preoperatively as having eithe … (vWF). Those still unresponsive to therapy received conjugated estrogens and, as a last attempt, a platelet transfusion. The administration of DDAVP led to a correction of platelet dysfunction in 229 of the 254 patients treated (90.2%). Tranexamic acid was effective in 12 of 16, aprotinin in 3 of 5, and factor VIII concentrates with vWF in all 4 patients with unrespo …

Iron Overload and Platelet Function Defects: Possible Correlation.

Acquired platelet function defect might be a consequence of iron overload. Even though there are various complications of iron overload, only few reports have indicated some correlations with platelets dysfunction. We report a child with Diamond-Blackfan anemia who has significant complications from iron overload due to chronic blood transfusion, and one of these complications is acquired platelet function defect that manifests with frequent episodes of epistaxis. Therefore, we emphasize the necessity for further studies to confirm direct correlation between iron overload as a causative agent

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… The child received platelets transfusion with no response as an attempt to control the frequent episodes of epistaxis. Therefore, we started him on recombinant factor VII as prophylaxis every 10 days, which showed a satisfactory control of bleeding over the last 2 years. … More specific tests, in particular, flow cytometry, is used to measure αIIbβ3 activation or α-granule secretion via P-selectin (CD62P) expression. 16 , 17 The treatment of choice in bleeding due to acquired platelets defect is platelet transfusion. However, other therapeutic agents are available. …

Platelet pheresis is not a useful adjunct to blood-sparing strategies in cardiac surgery.

OBJECTIVE: To examine whether specific platelet pheresis (minimal plasma harvested) would contribute toward reduced blood loss and allogenic blood requirements after cardiac surgery. DESIGN: A prospective randomized trial. SETTING: A large cardiothoracic surgical center. PARTICIPANTS: Consenting patients undergoing routine coronary artery or valve surgery (n = 54). INTERVENTIONS: Patients in the pheresis group underwent platelet pheresis in the anesthetic preparation room before general anesthesia. Pheresed platelets were stored during cardiopulmonary bypass and were returned to the patien

A survey of physicians' attitudes to transfusion practice in critically ill patients in the UK.

This study aimed to examine the attitudes of intensivists and haematologists to the use of blood and blood products using a scenario-based p … 05) modified the transfusion threshold. There were greater variations in the baseline threshold for platelet transfusion. The majority of respondents (72.3%) selected a baseline haemoglobin threshold between 9 and 10 g.dl(-1). The thresholds for platelet transfusion were far less consistent.

Risks of fresh frozen plasma and platelets.

Both fresh frozen plasma (FFP) and platelets are heavily used in massive transfusion. Although FFP can partially correct abnormal coagulation, a recent systematic review revealed no randomized trials showing clinical benefit. Although the overall risks of FFP and platelets are low, they are the least safe blood components, due to immunologic reactions such as allergy/anaphylaxis, transfusion-related acute lung injury (TRALI) and hemolysis due to anti-A or anti-B if transfused across ABO groups. TRALI, an acute syndrome of dyspnoea, hypoxia and pulmonary 'white-out' is now a major cause of tran

How I manage neonatal thrombocytopenia.

Although neonatal thrombocytopenia (platelet count < 150×10(9) /l) is a common finding in hospital practice, a careful clinical history and … f NAIT. Recent studies suggest that more than half of neonates with severe thrombocytopenia receive platelet transfusion(s) based on consensus national or local guidelines despite little evidence of benefit. The most pressing problem in management of neonatal thrombocytopenia is identification of safe, effective platelet transfusion therapy and controlled trials are u …

[A case of chronic subdural hematoma associated with idiopathic thrombocytopenic purpura (ITP)].

We reported a case of ITP associated with chronic subdural hematoma. A 51-year-old female was admitted to our hospital with left frontal pain on November 18, 1995. CT and MRI examinations revealed a left chronic subdural hematoma. Peripheral platelet count showed thrombocytopenia, 5,000/mm3. She was treated preoperatively by administration of steroids, a large dose of immunoglobulin and transfusion of platelet. Five days after admission, platelet count had elevated to 199,000/mm3, and evacuation of the hematoma through a burr hole under local anesthesia was performed successfully. No troubles