Blood transfusions are becoming more frequent in patients with aplastic anemia, what should I do?

Xiebielu Studio WeChat add369456 article source: Reposted from WeChat public account [Xiebielu Studio] Many aplastic anemia patients have discovered such a problem, that is, after a long period of illness, the blood transfusion interval is getting shorter and shorter, and the maintenance time after blood transfusion is also short. After that, the blood picture did not rise significantly. What was the reason? It is mainly considered from the following aspects:    The first aspect is the poor hematopoietic ability of the bone marrow, which includes two factors. One is that the aplastic anemia itself is getting worse, because aplastic anemia is a disease of bone marrow hematopoietic failure. There are fewer and fewer stem cells, and fewer and fewer mature cells are produced. There is also a possibility that the patient’s bone marrow hematopoietic stem cells are not many, but the cells produced are diseased cells, just like our factory production Some of the products are defective products. These blood cells have a relatively short lifespan and are quickly destroyed. The second reason is hemolysis. After hemolysis occurs in some patients with aplastic anemia, not only blood cells produced by bone marrow, but also blood cells transfused into other people’s blood will also cause hemolysis. In this case, CD55 and CD59 must be reviewed to see if it is correct. It is not combined with red blood cell defects, and even the disease turns into aplastic anemia-paroxysmal nocturnal hemoglobinuria syndrome. In response to such changes, our treatment should also be adjusted accordingly. If it is a problem with hematopoietic function, the condition is still aplastic!    Patients who need long-term blood transfusion need to monitor serum ferritin frequently, and extend the transfusion interval to control the amount of blood transfusion. Patients with high iron load can be treated with deferoxamine after infusion of 25-50 units of red blood cells, or when the serum ferritin level exceeds 1000-2000ug/L. Deferoxamine will combine with iron ions to form a macromolecular iron amine complex that is excreted in the form of urine and feces to prevent iron overload and iron deposition in various organs in the body, and reduce the promotion of lipid peroxidation and freedom due to iron overload Base generation, reduce hemolysis. However, the gastrointestinal absorption rate is low, and it can only be injected continuously intravenously or subcutaneously slowly. However, long-term use of deferoxamine will affect the vision and hearing of patients. Therefore, patients with aplastic anemia need regular blood analysis to reduce complications.   In this regard, it is recommended that some blood disease patients who have developed blood transfusion dependence change treatment as soon as possible, gradually get rid of blood transfusion, stabilize the blood picture in a safe range, and avoid unnecessary risks.