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Transfusions and Iron Overload Blood and platelet transfusions, iron testing and treatments

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  #1  
Old Tue Jun 15, 2010, 10:07 PM
bebop bebop is offline
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blood rejection

do any of you know what happens when the patients body starts rejecting the transfusions?
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  #2  
Old Tue Jun 15, 2010, 10:47 PM
rose mcmillin rose mcmillin is offline
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I wish I had answers for you. Someone on this site has probably been there and can address your concerns. I wish you well. Rose
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Husband diagnosed 10/08 RAEB-2 Started Vidaza treatments in Jan 09 until now
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  #3  
Old Wed Jun 16, 2010, 01:06 AM
Chirley Chirley is offline
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Hi,

I don't quite know what rejecting transfusions means.

If it's the same problem I have then it's to do with having so many transfusions that you develop antibodies and it becomes harder and harder to find donors that match.

I now have to have my x match test done at least 24 and preferable 48 hours before the transfusion is needed. I'm also pre medicated with steroids and anti histamine injections.

I hope this has helped.
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Copper deficiency bone marrow failure (MDS RAEB 1), neuromyelopathy.
FISH reported normal cytogenetics but gene testing showed
Xq 8.21 mutation
Xq19.36 mutation
Xq21.40. mutation
1p36. Mutation
15q11.2 deletion
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  #4  
Old Wed Jun 16, 2010, 08:55 AM
bebop bebop is offline
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thanks. I am not sure either what it means but my Dad's dr said he would eventually start rejecting them. I know at this time it is starting to not make a big difference in his blood counts and how he feels after. Yesterday after he had 3 units he got really sick to his stomach but not sure if he ever really threw up or not. He also has the rcmd kind but high risk now.
They always do his xmatch the day before transfusions.
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  #5  
Old Wed Jun 16, 2010, 05:35 PM
squirrellypoo squirrellypoo is offline
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Is it platelets he's rejecting? I was doing that for months. If you've had lots of transfusions, your body can develop antibodies against some variations of platelets, so you fight against them. For me, I knew when I was rejecting the bag because an hour or so after my platelet transfusion, I'd get REALLY sleepy.

So they usually give everyone "pools" of platelets, which means that the platelets in one bag come from a bunch of different people, so there's tons of different antigens floating around in there. Most people don't have problems, and this is the only kind they ever get. If you have a bad reaction, you'll get given piriton & hydrocortizone before each subsequent transfusion to stop the reaction, but if your counts don't jump after the transfusion (ie: you've rejected/attacked them), the next step is to give you "single donor" platelets. In those, all the cells in the bag come from just one person, so there's way less antigens, so less of a chance you've built up antibiodies against those. But if you're unlucky like me, you'll STILL reject the single donor platelets, which means you require HLA-matched platelets, which are hugely expensive and a logistical nightmare, because they need to get donors who are very closely genetically matched to you to donate at the right time when you need them and get them whisked to you before they expire. And even then, some donors work better than others. So it was procedure for all HLA-matched transfusions that they'd take a blood count an hour after the transfusion to make sure the count incremented, and it was noted down in the records that that particular donor worked well for this patient.

(ugh even just typing this all out makes me so grateful I don't have to do this anymore!)

I hope this helps!!
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36/F - 1984 SAA treated with ATG [complete remission until] Oct 08 - burst blood vessels in eyes and low platelets; Jan 09 - AA & hypo-MDS; July 09 - BMT (RIC MUD PSCT) July 10 - 10k for Anthony Nolan (1yr post BMT! 53:48) Sep 10 - Wedding! I've run 5 marathons now!! (PB 3:30!)
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  #6  
Old Wed Jun 16, 2010, 09:40 PM
bebop bebop is offline
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no not platelets. I think maybe I used the wrong terminology but hey I am stressed lol. I know his blood counts are not staying above 7 something right now. last monday was 7.9 after a transfusion of 2 units the Wednesday prior to that. This monday they were 6.3 so he is going thru the blood fast now.
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  #7  
Old Wed Jun 16, 2010, 11:41 PM
Chirley Chirley is offline
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Hi,

As far as I understand it, there are 3 ways of having reduced RCC. One is to not produce them (low retics), the 2nd is to destroy them (e.g auto immune etc) and the 3rd is to lose them (bleeding). You can have one of these reasons or a combination of any or all of the reasons.

Don't quote me, I've been known to be wrong on a few (many) occsions.
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Copper deficiency bone marrow failure (MDS RAEB 1), neuromyelopathy.
FISH reported normal cytogenetics but gene testing showed
Xq 8.21 mutation
Xq19.36 mutation
Xq21.40. mutation
1p36. Mutation
15q11.2 deletion
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  #8  
Old Thu Jun 17, 2010, 10:39 AM
bebop bebop is offline
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hahaha cme I totally understand that! lol me too. he apparently has like a complete marrow failure right now not making any cells at all. so the transfusions don't even help anymore. he went from a 7.9 on one monday and the next monday was already at a 6.3 so they just aren't working at all now
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  #9  
Old Thu Jun 17, 2010, 11:41 AM
squirrellypoo squirrellypoo is offline
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Hi bebop. It doesn't necessarily sound like he's rejecting the blood he's receiving - it's just not lasting as long as it used to? That's just the way things go with bone marrow failure, I'm afraid. I started off only needing transfusions every 3-4 weeks in late 2008, and by June 2009 I was getting four transfusions every week (2 red and 2 platelets). That's not to say everyone's increase is that sharp and fast, but it does tend to go that way without treatment... What do the doctors say about possible treatment options?
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36/F - 1984 SAA treated with ATG [complete remission until] Oct 08 - burst blood vessels in eyes and low platelets; Jan 09 - AA & hypo-MDS; July 09 - BMT (RIC MUD PSCT) July 10 - 10k for Anthony Nolan (1yr post BMT! 53:48) Sep 10 - Wedding! I've run 5 marathons now!! (PB 3:30!)
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  #10  
Old Thu Jun 17, 2010, 09:24 PM
bebop bebop is offline
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Dad opted for no treatment other than the transfusions. only the red cells so far. I honestly don't think he will last more than a couple of weeks at best. Today he was coughing up blood a little bit and this afternoon he has a slight temp. He is short winded now too but still able to be up at this point but laying in his recliner. This is so hard to watch. He is my rock, my world.
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  #11  
Old Fri Jun 18, 2010, 03:14 AM
JyotikaK JyotikaK is offline
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You are not alone! Just hang in there

Hi there!

Not much to say really but just read your post and know exactly how you feel. I look at my dad everyday and have all sorts of weird thoughts going through my head and I know it keeps getting harder and harder not being able to do much to help them in this condition. Just want you know you are not alone. I guess we just have to be strong for them. Thats how I am getting through this.

Will pray for him too.

Regards,

Jyotika
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Jyotika, Daughter of Ramesh, RAEB I, Dx 2009 July, on supportive care with RBC transfusions 3-4 weeks and platelet transfusion as and when required.
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  #12  
Old Fri Jun 18, 2010, 02:39 PM
bebop bebop is offline
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thank you Jyo. yes it is very difficult knowing for Dad the end is so near. He was just diagnosed in March this year. Watching is horrible. I really thought I would be strong but I am anything but that. Thanks for being here and I will be here for you as well. (((hugs)))
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  #13  
Old Tue Jun 29, 2010, 05:04 PM
bebop bebop is offline
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well Dad isn't rejecting the blood but his marrow is doing nothing so the blood is just not lasting long now. yesterday's numbers were horrible!

wbc 14.2
rbc 1.82
hemo 5.2
hemocrit 16.2
plts 20


he was extremely weak but after the plts transfusion he seemed to perk up a tad then 3 units of blood and today he is feeling a little better.

anyone know how long he can go like this? he normally goes every 2 weeks for cbc and blood but this time he has to go back in a week.
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  #14  
Old Thu Jul 22, 2010, 11:41 AM
BBTALKER BBTALKER is offline
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It is difficult to answer because I am not certain you mean rejection or some form of antibody incompatibility. Typically those who receive multiple transfusions, as well as those who have been pregnant, can produce antibodies to the red cell antigens ( foreign) from a donor. Because state and federal requirements govern pre-transfusion testing, these incompatibilities are usually picked up at the time of testing, but there may be some situations where there is a anamnestic response. These can be minor or severe.
The fact that you may have some urticaria or hives does not qualify as a significant reaction, but is stilll considered an adverse event. If this happens, you can be assured your MD will administer Benadryl or steroids prior to your next transfusion. Adverse events run the gammit of hives to renal failure and sometimes even death, but you can rest assured that there are medical professionals who test your blood prior to the actual transfusion. You must be an informed patient. Speak to your doctor. A patient has a right to make infomed decisions. You must receive the risks, benefits and alternatives to your treatment, so you can make the best choice for you and you must be given the opportunity to ask questions. Donor units are tested from a myriad of diseases, but although safe, there are always new diseases, bacteria, parasites and viruses on the horizon.
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