From 11/1995 to 4/1999 we treated by prednisone for 15 patients and CsA for 16 ones with idiopathic aplastic anemia. Results:- Prednison did not change significantly TCD3, TCD4 and TCD8 colony count comparing with pre-treatment (P>0.05).- CsA decreased clearly TCD3 colony count after 1st, 6th month (P<0,05). However, TCD4 colony count decreased not significantly (P>0.05). Conclusions: CsA has more suppressive effect on T-cell colonies, mainly TCDz3 and TCD8 than Prednisone and therefore it may be chosen to treat patients with idiopathic aplastic anemia without indication for bone marrow transplantation.
Anemia, Aplastic ; therapy ; blood ; therapeutics ; cyclosporine

OBJECTIVE: To examine the influence of erythropoietin (Epokaine prefil(R)) on transfusion requirements, serum hemoglobin levels in patients with gynecologic malignancies under polychemotherapy and chemotherapy associated anemia. METHODS: From January 2001 to March 2003, 70 patients treated with chemotherapy due to gynecologic cancer from Severance hospital were included into this study. Patients were assigned to one of two groups (case group (n=28) and control group (n=42)). Patients in case group received 2000 U or 6000 U Epokaine(R) subcutaneously two or three times a week for more than 3 cycles (9 weeks), and patients in control group didn't received Epokaine(R) (n=42). If the hemoglobin levels of 1st, 2nd and 3rd cycle >1 g/dL above the baseline value and/or >12 g/dL, patients were classified as responders. Patients who required blood transfusions or if the hemoglobin levels of 1st, 2nd and 3rd cycle <1 g/dL were as non-responders. RESULTS: 28 cases of 70 patients were assessable for response and complication to Epokaine(R) application. In the Epokaine(R) group, 53%, 64%, 71% of the patients responded to the treatment (at 1st, 2nd and 3rd cycle, respectively) and only 7 patients (21.4%) required blood transfusions, whereas 28 patients in control group (66.7%) needed transfusion. Mean transfused units were 1.56 in case group and 3.55 in the control group (P=0.03). In case group, mean hemoglobin levels were significantly increased after the 1st, 2nd and 3rd cycle of chemotherapy (0.73 g/dL, 1.34 g/dL, 1.65 g/dL, respectively) compared with the mean baseline value. CONCLUSION: We concluded that Epokaine(R) significantly decreases transfusions requirements and increases serum hemoglobin levels in patients with gynecological malignancies who are undergoing polychemotherapy. Therefore, Epokaine(R) would be effective in the treatment of anemia of gynecologic cancer patients receiving polychemotherapy.
Anemia* ; Blood Transfusion ; Drug Therapy ; Drug Therapy, Combination ; Erythropoietin* ; Humans*

Anemia, Aplastic ; therapy ; Fetal Blood ; transplantation ; Humans ; Mesenchymal Stromal Cells

Blood loss and blood transfusion requirement are important quality control indicators of cardiovascular surgery and cardiovascular anesthesia. Patient blood management (PBM) is an evidence-based, multidisciplinary approach to optimizing the care of patients who may need transfusion, which encompasses anemia management, hemodilution, cell salvage, hemostatic treatment, and other approaches to reducing bleeding and minimizing blood transfusion. PBM in cardiovascular surgery is a "team sport" that involves cardiac and vascular surgeons, anesthesiologists, perfusionist, intensivists, and other health care providers. The current work provides an overview of evidence and practice of PBM at Fuwai Hospital. Implementation of PBM should also take local resource availability and cost-effectiveness of different devices, drugs, technologies, and techniques into consideration.
Humans ; Blood Transfusion/methods* ; Anemia/therapy* ; Hemorrhage ; Hospitals ; Blood Loss, Surgical

In thirty patients with acute leukemia and severe aplastic anemia receiving random single donor platelet transfusions, the development of refractoriness by consecutive platelet transfusions with cytapheresis and its relationship to the appearance of anti-platelet antibodies were investigated. The median number of platelet transfusions inducing refractoriness was 13 times, and 20% of the patients remained unrefractory despite of the repeated multiple platelet transfusions up to 20 to 25 times. The results of anti-platelet antibody tasts by the enzyme-linked immunosorbent assay(ELISA) and immunofluorescent techniques(IFT) showed no statistically significant relationship with the refractoriness (p greater than 0.1). Although there was significant correlation between the results of ELISA and IFT, both tests were insufficient to find out refractoriness even with the use of pooled platelets from multiple donors as target cells. This study shows that 13 single donor platelet transfusions result in refractoriness, that both ELISA and IFT are insufficient to detect refractoriness despite of their significant correlation, and that other methods than these are needed in order to detect alloimmunization.
Adolescent ; Adult ; Aged ; Anemia, Aplastic/therapy ; Anemia, Refractory/*etiology ; Antibodies/metabolism ; *Blood Platelets/immunology ; *Blood Transfusion ; Female ; Humans ; Leukemia/therapy ; Male ; Middle Aged

The purpose of this study was to review the clinical hematological, immunological features and treatment responsiveness in children with autoimmune hemolytic anemia (AHA). Eight children with AHA and positive Coombs' test was evaluated. Seven patients presented with acute onset of symptoms and histories of infection. One case was diagnosed as Evans syndrome, one as a chromosomal anomaly, and one case was combined with the Guillain-Barre syndrome. Among 8 the patients, 4 exhibited warm antibodies and the remainder had cold antibodies. The patients were given washed packed red blood cells, prednisolone or immunosuppressive drugs (6-MP or cyclophosphamide). Five patients responded well to transfusion and/or prednisolone, one patient died and one patient showed no response in 5 months of follow up.
Adolescent ; Anemia, Hemolytic, Autoimmune/blood ; Anemia, Hemolytic, Autoimmune/diagnosis* ; Anemia, Hemolytic, Autoimmune/therapy ; Child ; Child, Preschool ; Coombs' Test ; Female ; Human ; Infant ; Male ; Retrospective Studies

OBJECTIVETo evaluate bone marrow hematopoietic cells genetic instability (BMHCGI) in patients with aplastic anemia (AA) and to explore its influence on immunosupressive therapy for AA and significance on late clonal hematologic disorders.

METHODSGenetic instability of bone marrow mononuclear cells (BMMNC) was measured by Comet assay. The relationship between bone marrow failure parameters and genetic instability results was evaluated. The reciprocity of genetic instability and treatment responses to immunosuppressive therapy (IST) was investigated.

RESULTSComet assay parameters \[tail moment (TM), olive TM (OTM), comet %\] of AA patients were significantly higher than that of control group (P < 0.05). There was no statistic correlation of comet parameters of severe AA (SAA) BM hematopoietic cells with age, gender and peripheral blood cell count (P > 0.05). For the treatment response rate at six months after IST there was no statistical difference between comet cells of < 21.64% and of >/= 21.64%, and so did between OTM < 1.58 and >/= 1.58 in SAA patients. IST had no effect on SAA BMHCGI, whereas, the Comet%, TM and OTM in SAA PR patients and Comet% in CR patients were significantly decreased than those before treatment. Comet parameters of two SAA patients were significantly increased before the development of clonal cytogenetic abnormalities.

CONCLUSIONSIncreased BMHCGI may be one of the elements in the pathogenetic mechanisms in AA. The genetic instability is irrelevant to the SAA patients overall response rate of IST at six months, but IST can alleviate the genetic instabilities in responded SAA patients.

Anemia ; therapy ; Erythrocyte Transfusion ; Exchange Transfusion, Whole Blood ; Female ; Hematocrit ; Hemoglobins ; analysis ; Humans ; Infant, Newborn ; Male

In order to screen the compatible red cells by using extracorporal hemolysis test for acute autoimmune hemolytic anemia (AIHA) patients who were difficult to be matched by automatic microcolumn gel indirect antiglobulin test. Twenty-six cases of AIHA were chosen as control group, to whom the same type of donor red blood cells were infused with the weakest blood agglutination; 12 cases of acute AIHA patients were chosen as test group, these patients were difficult to be matched by automatic microcolumn gel indirect antiglobulin test, and the donor red cells without hemolysis by extracoral hemolysis test were transfused for them. The results showed that compared with the control group,the effect of transfusion was better in test group (P < 0.01), with 2.26 U leukocyte-depleted erythrocyte suspension in average, whose hemoglobin, reticulocyte and total bilirubin levels were changed significantly compared with those before blood transfusion (P < 0.01) . It is concluded that the compatible red blood cells for the acute AIHA patients can be screened by the extracorporal hemolysis test, when it is difficult to screen by the automatic microcolumn gel indirect antiglobulin test.
Anemia, Hemolytic, Autoimmune ; therapy ; Blood Transfusion ; Coombs Test ; Erythrocyte Count ; Erythrocytes ; Hemolysis ; Humans ; Platelet Transfusion

OBJECTIVETo compare the effect of different indications of blood transfusion on the treatment and complications in anemia of prematurity, and to investigate the suitable and reasonable indication of blood transfusion for our country.

METHODSNinety six hospitalized premature infants with birth weight less than 1500g and stay in hospital equal or more than 2 weeks were enrolled in the retrospective study and divided into two groups according to different indications of blood transfusion. There are 54 cases in observation group 1 (with strict indications for transfusion) and 42 cases in observation group 2 (with loose indications for transfusion).

RESULTSIn the observation group 1, the total amount of blood transfusion \[M(P25, P75):71.0(43.25, 107.25) ml\] and the times of blood transfusion \[3.00 (2.00, 4.00) times\] are both higher than those of the observation group 2 \[36.0 (29.50, 56.25) ml and 1.50 (1.00, 2.25) times, respectively, P = 0.00 1\]. The days of mechanical ventilation and the days of continuous positive airway pressure were more in the observation group 1, but oxygen supplement in the two groups had no significant difference. In observation group 1, the incidence of intracranial hemorrhage, fungal infection rate and mortality were higher than those of the observation group 2 (P < 0.05).

CONCLUSIONSAnemia of prematurity easily led to the complications, and had obvious influence on the survival of premature infants. Clinician should consider concrete conditions of every patient before blood transfusion. It has positive significance on the survival of premature infants to loosen the indication properly and make the use of blood scientifically and rationally.