What's the lowest HB an adult male can tolerate without transfusions?

[SAA Sister]

My brother is one month post ATG and they are trying to give him the least amount of blood products possible while we wait to for them to confirm a possible matched unrelated donor. He has in a space of a week dropped from a Hb of 77 to 67 g/L or 6.7 g/DL, I know it depends on what he is able to tolerate and he seems to be tolerating it preety well but I worry that we probably shouldn't go too much under this with his weight at 108kgs. What is the lowest an adult male can go? Is the risk of developing antibodies to blood products if he will have a BMT greater than the risks of living with such a low hb count?

[sbk007]

Originally Posted by SAA Sister

My brother is one month post ATG and they are trying to give him the least amount of blood products possible while we wait to for them to confirm a possible matched unrelated donor. He has in a space of a week dropped from a Hb of 77 to 67 g/L or 6.7 g/DL, I know it depends on what he is able to tolerate and he seems to be tolerating it preety well but I worry that we probably shouldn't go too much under this with his weight at 108kgs. What is the lowest an adult male can go? Is the risk of developing antibodies to blood products if he will have a BMT greater than the risks of living with such a low hb count?

In the U.S for a male they usually want to give blood if HGB is less than seven, for the elderly its 8. However, a lot of doctors now feel that 8 is a better number b/c it gives the patient a better quality of life. How low can it go depends on the individual, I've heard of people with HGB of 3 before they realized something was wrong. There are people on here that have had a hundred or more transfusions and they're still posting. Is it possible the ATG will start working and he wont need the transplant? I hope so. Hope this helps.

[Lbrown]

I've had over 200 units of red cells over 4 years, and I have no blood antibodies.

I try to keep my HGB above 80, although I think my transfusion low limit is 90.

Deb

[StephM]

Hey! I'm following your thread with great attention. I am asking myself exactly the same question.
Doctors said they would not do a second round of atg if this one doesn't work but they would do a BMT (unrelated donor). But my brother had so many transfusions since July...
After transfusions, his HB is around 8 and he needs one at least every week. Same for platelets. But they always ask the same donor. So that they are sure he tolerates it well I guess (I wonder how long it takes that person every week to give his/her platelets...)
Let's hope the first round of ATG will be sufficient for our brothers.

What about the white cells? What do they do if the number of neutrophils doesn't rise? My brother's were still 200 today and he should be released from hospital next week.

Bon courage SAA Sister!

[Whizbang]

Doctors prescribe Nueprogen for increasing WBC's, but that 'may' increase the risk of 'increased blasts' (although may studies have been done that contradict this), it's still a risk.