Sangre
-
Donor leukocyte infusions (DLI) are useful for treating leukaemic relapse after allogeneic bone marrow transplantation (BMT). We reviewed our experience with eleven patients who received DLI between 1995 and 1997. ⋯ DLI results in CR in most patients with relapsing leukaemia or myelodysplasia after BMT, especially in CML patients. The anti-leukaemia effect is highly correlated with GVHD. This complication and marrow hypoplasia remain major causes of morbidity and mortality of this procedure.
-
The aim of this paper is, first, to know the actual situation of the perioperatory red cell transfusion for elective surgery in our hospital. In a second phase and prospectively, we tested guidelines for red cell perioperatory transfusion in order to observe the change of transfusions. Then, we compared the results between the basal and postintervention periods. ⋯ 1) The transfusional activity of the Marina Alta Hospital supposes approximately 17% of the request and 6% of the global transfusion. 2) The introduction of a protocol of perioperative transfusion instructions suppose a small decrease of the crossmatch--to--transfusion ratio, without statistical significance. This slight reduction is due to an increase of transfusion in the post-intervention period, since in this period there is a group of older age patients and with greater percentage of associated pathology. 3) The rate of appropriate transfusions in both periods is similar. 4) The preoperative request of red cells is inappropriate. 5) The most frequent reason of inappropriate transfusion is active bleeding.
-
[Infectious and non-infectious complications of tunneled central catheters in hematologic patients].
Long-term therapy of haematology patients has been facilitated by permanent indwelling central venous catheters. We performed a retrospective study to compare the problems occurring with a externalized catheter (Hickman) versus a totally implanted port catheter. ⋯ We found a significantly increased incidence of catheter-related infection in patients with Hickman catheters. We also observed that the use of intravenous antibiotic prophylaxis prior to catheter insertion did not appear to be beneficial and thrombocytopenia at this moment was a factor in the development of hematoma. The infections due to coagulase-positive staphylococci can be treated successfully without removal of the catheters. However in catheter-related bacteremia due gram-negative organisms there is a chance that the bacteremia will recur if the catheter is not removed.
-
The results of the treatment with lymphoblastoid alpha interferon (IFN-alpha N1) in 10 patients with chronic myeloid leukaemia who had poor response to previous recombinant alpha interferon (rIFN-alpha) are presented. Eight of these patients had not developed anti-alpha 2 interferon antibodies, and 2 had non-neutralising anti-IFN antibodies. Three of the 10 patients received benefit from IFN-alpha N1 treatment. ⋯ The third patient, after receiving rIFN-alpha for 3 years with no response, had partial cytogenetic response after 4 months of treatment with IFN-alpha N1. These results suggest that IFN-alpha N1 when used in patients refractory to IFN-alpha N1. These results suggest that IFN-alpha N1 when used in patients refractory to IFN alpha 2 without anti-IFn alpha 2 neutralising antibodies may be useful in a minority of patients, although the frequency of cytogenetic responses is low.