Prediction of IO in MDS and AML Patients undergoing aSCT

[akita]

http://ash.confex.com/ash/2010/webprogram/Paper31120.html

3493 Comparing the Value of Serum Ferritin, Transfusion History and Magnetic Resonance Imaging for the Prediction of Iron Overload In MDS and AML Patients Undergoing Allogeneic Stem Cell Transplantation

"Our data suggest that serum ferritin or transfusion history cannot be regarded as robust surrogates for the actual iron overload in MDS or AML patients. Therefore we advocate caution when using one of these parameters as the only trigger for chelation therapy or as a risk-factor to predict outcome after allo-HSCT."

[usaf1125]

I have been getting transfusions for 10 years, so far I have had 384 units of PRC I take nothing for the Iron, my level is always off the charts, 2500+. I haven't had a adverse reactions, I'm not rusting, my Dr. is OK with it.

[Mseth]

Hi usaf1125,

My mother is on a supportive care regime of pRBC transfusions for last 16 months, almost 40 units so far, averaging 2 units every 3 weeks.
Have you had prolonged spells of low grade fevers? She is currently battling a fever for last few weeks without any conclusive diagnosis on the cause. Maybe it is because of mds.
Have your other counts- whites and platelets remained stable in these last 10 years?

Thanks in advance for your reply.

[usaf1125]

all my numbers vary, sometimes normal, sometimes high, sometimes low. When I first started I got a fever after an infusion. they started to pre med me with, Tylenol, Benadryl, and Hydrocortisone, that took care of the fever. It is a very strange disease.

[Mseth]

Hi usaf1125,

Thanks for your reply.

Yes, no doubt MDS is a strange disease.

Doctor is ok with premedicating with Tylenol, but no antihistamine like Benadryl. Could you tell me what is hydrocortisone used for? I also think Tylenol reduces platelet count though that may happen with prolonged use.

I have one more questions for you - has your transfusion requirement increased over the years or have you been on a similar frequency for last 10 years? I am always worried for my mother that her disease will progress and she will need even higher frequency of transfusions. No treatment has worked so far.

[usaf1125]

I have no idea what the Hydrocortisone is for, I don't dwell on anything, I do what my Doctors tell me to do and what to take. In the last year and a half my infusions have gone from every 2 or 3 weeks, to 6,7,8,9 weeks. Crt goes up and down, 29.5, next time 30.8. I have had 348 units of PRC. It is strange

[Mseth]

Hi usaf1125,

Thanks for your reply. It's great that you are requiring less transfusions, are you on some active treatment regime that is helping? What is CRT? I tried to google CRT but could not find anything relevant.

Thanks.