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Speciality Spotlight
Transfusion
Medicine
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Wandt H, Frank M, Ehninger G, et al [ Inst of Medical Oncology and Hematology, Nurnberg, Germany; Med School Hannover, Germany; Technical Univ Dresden, Germany ]
Safety and Cost Effectiveness of a 10 * 109/L Trigger for Prophylactic Platelet Transfusions Compared with the Traditional 20 * 109/L Trigger : A Prospective Comparative Trial in 105 Patients with Acute Myeloid Leukemia
Blood 91: 3601-3606, 1998
This study compares two groups of patients group A [n=58] were transfused at a morning platelet level of 10 * 109/L, and group B [n=47] at a level of platelet 20 * 109/L. The cost of platelet therapy was one-third lower for group A than for group B, bleeding risks were not increased. The editor comments that by keeping the lower threshold for platelet transfusion combined with measures such as leukocyte filtration and ultraviolet irradiation to prevent alloimmunization and development of refractoriness will improve the utility of prophylactic transfusions to prevent bleeding and lower the cost.
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Barosi G, Marchetti M, Liberato NL [ IRCCS Policlinico S Matteo, Pavia, Italy ]
Cost-effectiveness of Recombinant Human Erythropoietin in the Prevention of Chemotherapy-induced Anaemia
Br J Cancer 78: 781-787, 1998
Chemotherapy induced anemia responds to recombinant human erythopoirtin [ rHuEPO ] however the dosage required high 150 u/kg subcutaneous three times a week for 4 months, reduced, the probability of transfusions from 21.9% to 10.4% and the numbers of RBC units per patient per month from 0.55 to 0.29. As per the data available in this study rHuEPO is not cost effective for treatment of chemotherapy induced anemia. The editor comments that the certain gains by without blood transfusion is difficult to ascertain these are the improved quality of life, the inconvenience associated with blood transfusion and the risk of HIV or hepatitis C virus.
