Splenectomy in Leukemia and Myelofibrosis: Changes in the Erythrocyte Values

Strumia, Max M.; Dugan, Ann; Taylor, Lawrence W.; Strumia, Paul V.; Bassert, D.; Sample, Albert B.

doi:10.1093/ajcp/37.5.491

Cited by 22 publications

(8 citation statements)

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“…Evidence of abnormal blood volumes in conditions accompanied by enlargement of the spleen has been found in cryptogenetic splenomegaly of Chinese subjects,22 Gaucher's disease,' myeIoitI metaplasia a n d leukemias,16. 35 primary hypersplenism,38 and tropical splenomegaly. 29 Expansion of blood volume in chronic anemic states also has been reported frequently.3.…”

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confidence: 99%

Blood Volume Studies in Patients with Splenomegaly

Bowdler¹

1970

Transfusion

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Estimations of erythrocyte mass, plasma, and total blood volume showed a significantly increased plasma volume in patients with splenomegaly from a variety of disorders. Venous hematocrit provided a poor indication of erythrocyte mass in these subjects. Plasma and total blood volumes showed positive correlation with clinical measurements of spleen size; a lesser correlation was found between spleen size and erythrocyte mass. Factors leading to expanded blood volume are reviewed, and significant components are suggested to be the intrasplenic blood volume and an increase in splanchnic blood volume consequent to obstructive or hyperkinetic portal hypertension.

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confidence: 99%

Blood Volume Studies in Patients with Splenomegaly

Bowdler¹

1970

Transfusion

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“…Increased blood volumes and plasma volumes due to splenomegaly have been found by other authors in adult patients with lymphoproliferative and myeloproliferative disorders (14,7,8,12,13,(19)(20)(21)(22). In these studies liver size has not been considered.…”

Section: Discussionmentioning

confidence: 60%

“…Anemia and hepatosplenomegaly are common findings in children suffering from leukemia. Blood volume studies in adult patients with splenomegaly due to myeloproliferative and lymphoproliferative disorders have revealed that blood volume and plasma volume increase in relation to spleen size, whereas red cell mass is less affected, resulting in hemodilutional anemia (3,4,8,11,21). We are not aware of any report on blood volume data of children with leukemia.…”

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confidence: 97%

Blood Volume of Children With Leukemia

Linderkamp¹,

Lau²,

Riegel³

et al. 1978

Acta Paediatrica

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Blood volume was measured using 125iodinated human serum albumin in 27 children with acute lymphoblastic leukemia, and in 7 children with various types of leukemia. Total blood volume was normal in patients without marked enlargement of spleen and liver, and increased progressively as spleen and liver size increased. The hypervolemia was entirely due to expansion of plasma volume. In the children with marked hepatosplenomegaly, only hematocrit (but not red cell mass) was below the normal range in most cases. Both hematocrit and red cell mass were subnormal in the majority of patients without considerably enlarged spleen and liver. Therefore, anemia in children with marked hepatosplenomegaly may be partly caused by hemodilution of red blood cells in expanded plasma volume.

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“…16,32,33 On average, the effect from each unit of red blood cells can vary from patient to patient according to age, height, blood storage time and presence of comorbidities such as renal failure and splenectomy. 34 Some controlling factors in this study need to be considered.…”

Section: 18mentioning

confidence: 99%

Red blood cell transfusions worsen the outcomes even in critically ill patients undergoing a restrictive transfusion strategy

et al. 2012

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CONTEXT AND OBJECTIVE: Anemia and blood transfusions are common in intensive care. This study aimed to evaluate epidemiology and outcomes among critically ill patients under a restrictive transfusion strategy. DESIGN AND SETTING: Prospective observational cohort study in an intensive care unit (ICU) at a tertiary hospital. METHODS: All adults admitted to the ICU over a one-year period who remained there for more than 72 hours were included, except those with acute coronary syndrome, ischemic stroke, acute hemorrhage, prior transfusion, pregnant women and Jehovah's Witnesses. The restrictive strategy consisted of transfusion indicated when hemoglobin levels were less than or equal to 7.0 g/dl. RESULTS: The study enrolled 167 patients; the acute physiology and chronic health evaluation II (APACHE II) score was 28.9 ± 6.5. The baseline hemoglobin level was 10.6 ± 2.2 g/dl and on day 28, it was 8.2 ± 1.3 g/dl (P < 0.001). Transfusions were administered to 35% of the patients. In the transfusion group, 61.1% did not survive, versus 48.6% in the non-transfusion group (P = 0.03). Transfusion was an independent risk factor for mortality (P = 0.011; odds ratio, OR = 2.67; 95% confidence interval, CI = 1.25 to 5.69). ICU stay and hospital stay were longer in the transfusion group ReSUMO CONTEXTO E OBJETIVO: Anemia e transfusões sanguíneas são comuns em terapia intensiva. O objetivo deste estudo foi investigar a epidemiologia e resultados em pacientes críticos sob o regime de transfusão restritiva. TIPO DE ESTUDO E LOCAL: Estudo de coorte, prospectivo e observacional em unidade de terapia intensiva de um hospital terciário. MÉTODOS: Foram incluídos todos adultos admitidos na unidade durante um ano e que permaneceram internados por mais de 72 horas, exceto pacientes com lesão coronariana aguda, isquemia cerebral aguda, hemorragia aguda, transfusão anterior, mulheres grávidas e testemunhas de Jeová. A estratégia restritiva consiste na transfusão indicada com a hemoglobina inferior ou igual a 7.0 g/dl. RESULTADOS: Totalizando 167 pacientes incluídos, APACHE II (Acute Physiology and Chronic Health disease II) foi de 28,9 ± 6,5. O valor da hemoglobina basal foi de 10,6 ± 2.2 g/dl e no 28 o dia foi de 8,2 ± 1.3 g/dl (P < 0,001). 35% dos pacientes receberam transfusões. No grupo de transfusão 61,1% não sobreviveram versus 48,6% do grupo não transfusão (P = 0,03). A transfusão foi fator de risco independente de mortalidade (P = 0,011; odds ratio, OR = 2,67; intervalo de confiança, IC 95% = 1,25-5,69). A internação na unidade de terapia intensiva e hospitalar foi maior no grupo de transfusão: 20,0 (3,0-83,0) versus 8,0 (3,0-63,0) dias (P < 0,001); e 24,0 (3,0-140,0) versus 14,0 (3,0-80,0) dias (P = 0,002). CONCLUSÕES: Em pacientes graves, observou-se redução da hemoglobina com a progressão da permanência na UTI. Além disso, a transfusão foi associada com piores prognósticos. I MD, MSc. Physician,

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Splenectomy in Leukemia and Myelofibrosis: Changes in the Erythrocyte Values

Cited by 22 publications

References 0 publications

Blood Volume Studies in Patients with Splenomegaly

Blood Volume Studies in Patients with Splenomegaly

Blood Volume of Children With Leukemia

Red blood cell transfusions worsen the outcomes even in critically ill patients undergoing a restrictive transfusion strategy

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