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Extent of transfusion support in a developing country in managing a bleeding acute myeloid leukemia patient with platelet transfusion refractoriness

Conventional platelet transfusion may not be adequate to deal with platelet transfusion refractoriness (PTR), and therefore human leukocyte antigen (HLA) or human platelet antigen (HPA) matched and platelet crossmatch compatible units are recommended. However, in developing countries, finding a unit...

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Autores principales: Chellaiya, Gayathiri K., Nair, Chandran K., Raghavan, Vineetha, Pandian, R. Jesu, Vinod, Roshan, Murugesan, Mohandoss
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8294443/
https://www.ncbi.nlm.nih.gov/pubmed/34349464
http://dx.doi.org/10.4103/ajts.AJTS_81_19
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author Chellaiya, Gayathiri K.
Nair, Chandran K.
Raghavan, Vineetha
Pandian, R. Jesu
Vinod, Roshan
Murugesan, Mohandoss
author_facet Chellaiya, Gayathiri K.
Nair, Chandran K.
Raghavan, Vineetha
Pandian, R. Jesu
Vinod, Roshan
Murugesan, Mohandoss
author_sort Chellaiya, Gayathiri K.
collection PubMed
description Conventional platelet transfusion may not be adequate to deal with platelet transfusion refractoriness (PTR), and therefore human leukocyte antigen (HLA) or human platelet antigen (HPA) matched and platelet crossmatch compatible units are recommended. However, in developing countries, finding a unit that is HLA or HPA matched or platelet crossmatch poses a challenge. Hence, easier and cost-effective alternatives such as massive platelet transfusion and continuous platelet transfusion were attempted to manage bleeding in PTR. A 31-year-old male presented with acute myeloid leukemia relapse and chloroma in bladder underwent FLAG salvage chemotherapy. Despite almost daily platelet transfusion with single donor platelets (SDPs), patient presented with hematuria and low corrected count increment at 1 h and 24 h suggesting both immune and nonimmune refractoriness to platelet transfusion. The patient received SDP transfusion twice daily from day 19 to day 21 to maintain hemostasis. The patient had persistent hematuria, so massive platelet transfusion in the form of double adult doses of SDP given every 12(th) hourly for three events. Despite these measures, there was persistent hematuria and refractoriness to platelet transfusion. As HLA or HPA matched or crossmatch compatible platelets were unavailable, continuous platelet transfusion was started for this patient from day 23 to day 28. After 4 days of continuous platelet transfusion, hematuria subsided. In resource-constrained clinical settings, continuous platelet transfusion can be an effective alternative to HLA/HPA-matched platelets in the management of PTR.
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spelling pubmed-82944432021-08-03 Extent of transfusion support in a developing country in managing a bleeding acute myeloid leukemia patient with platelet transfusion refractoriness Chellaiya, Gayathiri K. Nair, Chandran K. Raghavan, Vineetha Pandian, R. Jesu Vinod, Roshan Murugesan, Mohandoss Asian J Transfus Sci Case Report Conventional platelet transfusion may not be adequate to deal with platelet transfusion refractoriness (PTR), and therefore human leukocyte antigen (HLA) or human platelet antigen (HPA) matched and platelet crossmatch compatible units are recommended. However, in developing countries, finding a unit that is HLA or HPA matched or platelet crossmatch poses a challenge. Hence, easier and cost-effective alternatives such as massive platelet transfusion and continuous platelet transfusion were attempted to manage bleeding in PTR. A 31-year-old male presented with acute myeloid leukemia relapse and chloroma in bladder underwent FLAG salvage chemotherapy. Despite almost daily platelet transfusion with single donor platelets (SDPs), patient presented with hematuria and low corrected count increment at 1 h and 24 h suggesting both immune and nonimmune refractoriness to platelet transfusion. The patient received SDP transfusion twice daily from day 19 to day 21 to maintain hemostasis. The patient had persistent hematuria, so massive platelet transfusion in the form of double adult doses of SDP given every 12(th) hourly for three events. Despite these measures, there was persistent hematuria and refractoriness to platelet transfusion. As HLA or HPA matched or crossmatch compatible platelets were unavailable, continuous platelet transfusion was started for this patient from day 23 to day 28. After 4 days of continuous platelet transfusion, hematuria subsided. In resource-constrained clinical settings, continuous platelet transfusion can be an effective alternative to HLA/HPA-matched platelets in the management of PTR. Wolters Kluwer - Medknow 2021 2021-06-12 /pmc/articles/PMC8294443/ /pubmed/34349464 http://dx.doi.org/10.4103/ajts.AJTS_81_19 Text en Copyright: © 2021 Asian Journal of Transfusion Science https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Case Report
Chellaiya, Gayathiri K.
Nair, Chandran K.
Raghavan, Vineetha
Pandian, R. Jesu
Vinod, Roshan
Murugesan, Mohandoss
Extent of transfusion support in a developing country in managing a bleeding acute myeloid leukemia patient with platelet transfusion refractoriness
title Extent of transfusion support in a developing country in managing a bleeding acute myeloid leukemia patient with platelet transfusion refractoriness
title_full Extent of transfusion support in a developing country in managing a bleeding acute myeloid leukemia patient with platelet transfusion refractoriness
title_fullStr Extent of transfusion support in a developing country in managing a bleeding acute myeloid leukemia patient with platelet transfusion refractoriness
title_full_unstemmed Extent of transfusion support in a developing country in managing a bleeding acute myeloid leukemia patient with platelet transfusion refractoriness
title_short Extent of transfusion support in a developing country in managing a bleeding acute myeloid leukemia patient with platelet transfusion refractoriness
title_sort extent of transfusion support in a developing country in managing a bleeding acute myeloid leukemia patient with platelet transfusion refractoriness
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8294443/
https://www.ncbi.nlm.nih.gov/pubmed/34349464
http://dx.doi.org/10.4103/ajts.AJTS_81_19
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