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Old Thu Jun 9, 2011, 08:55 PM
freedom99 freedom99 is offline
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Join Date: Jun 2011
Location: Leamington, Ontario, Canada
Posts: 40
Platelet Levels to transfuse

Hi Neel;
My wife has MDS as described in my signature. Her transfusion protocol for platelets is 20,000, She gets blood work twice a week at the hospital lab who contact the treatment dept within a few hours and transfusions are set up twice a week. At this stage the platelets are staying at anywhere from 6,000 to 16,000 so transfusions are twice a week with 5 units each time.
The important thing to remember is that there are about seven different types of MDS and even within those types there are different types of reactions.
Even at 6,000 my wife has very few symptons of bleeding. There is a bit of bruising and a bit of bleeding that stops fairly quidkly. Whereas there are other patients with MDS where there is bleeding at higher platelet levels.
The nurse at the oncology treatment lab tells us to watch for bleeding that doesn't stop and if that's the case go to emergency where they will set up an emergency platelet transfusion. The interesting thing when platelets are transfused they go directly to the bleeding site. A miracle of the body.
Think about prevention of bleeding if platelets are low by not brushing teeth hard. no dental work, no aspirin or antiinflamatory meds. Ask your pharmacist or doctor which ones to watch for.
Your doctor should know what platelet level is serious for you and what to look for beside the obvious of a very dark stool, cuts don't stop or from hemaroids that don't stop.
There is the petechiae which is the red spots on the lower part of the legs. I've not seen them on my wife's legs. One doctor said that this is a sign a transfusion is necessary.
I've read somewhere else that with some MDS types that maintaining platelets at 5,000 is adequate. I wouldn't risk that myself. My doctor asked me if I was comfortable with 20,000 and I'm going with that.
My wife's hemaglobin is kept at 80. This number is a Canadian number I think which is different than what's used in the US. This involves two units of RBCS every two weeks.
Again, this disease can be confusing and the treatments having a different effect for everyone. At the same time if we are well informed of other peoples situations we can hopefully get a better overall picture of our own situation and can make better decisions. Remember, very few doctors make the decision for you. they give the pros and cons and ask you to make the final decision.
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Wife 63, June 2010 MDS (refr anemia - excess blasts type-2) PLTs 11,000/μl with giant forms 2 TF/wk. Hgb kept at 80g/l with 1TF per 2 weeks. 9% blasts 2 cytogenic abnormalities del(5)(q22q35) + inv(20)(p11.23q11.21) 3 cycles Vidaza no effect. June 2011 to AML WBC to 67 blasts and Aur rods in blood.
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