Blood cell substitution within the scope of hematologic intensive therapy for supportive hemotherapy with erythrocyte, thrombocyte and granulocyte concentrates
Helbig, W.; Kubel, M.
Zeitschrift für die Gesamte Innere Medizin und ihre Grenzgebiete 43(20): 561-566
1988
ISSN/ISBN: 0044-2542 PMID: 3062934 Document Number: 312162
Nowadays the application of blood cell concentrates corresponding to indication is in nearly all cases superior to the whole-blood transfusion. For the substitution of erythrocytes are to be recommended buffy coat-free concentrates, for special indications also cryopreserved ones in order to avoid complications (sensitization, transmission of viruses). Concentrates of thrombocytes are to be administered nearly exclusively in disturbances of formation and may be used for the short-term application as pooled randomized preparations, in a medium period better may be used as individual donor preparation. In order to avoid sensitizations, but always when HLA-antibodies occur, HLA-compatible individual donor concentrates must be used. Particularly in the patient with immune deficiency the possible transmission and the growth of stem cells with subsequent graft-versus-host disease (therefore the concentrates should be irradiated with 15-30 Gy) and the transmission of cytomegaly viruses (CMV), respectively, which can be minimized using CMV-negative donors, is to be taken into consideration. Prophylactically applied concentrates of thrombocytes evidently co-determine the therapeutic success of the highly aggressive chemotherapy; transplantation of bone marrow could not be performed without them. On account of the danger of the transmission of CMV concentrates of granulocytes are administered only strongly therapeutically in life-threatening infections, when the patient shows a decrease of the number of granulocytes below 0.5 Gpt/l. However, the substitution must be performed consequently over at least 3 days and up to the proof of clinical effectiveness, respectively.