Non-responsive HGB to transfusion

[Mary4Mike]

Has anyone experienced a non-reponse to a TX?

My husband has had 7 units of PRBC since March 3rd (HGB 6.5) and today his HGB was 7.7. I will add that he has done 3 rounds of Dacogen and is currently in the hospital with pneumonia. He has been running a fever during this whole time frame.

His other counts have rebounded somewhat from his Dacogen nadir: WBC 3.2, PLT 339, RBC 2.78. ANC 2.8. He finished his 3rd cycle on Feb 22.

I am looking for any input, ideas or suggestions.

Thanks in advance.

[poppyshope]

Has anyone used the term refractory? At the end of my dad’s inductive chemo he needed platelets daily, and they were worried he would or had become refractory. They gave him the platelets and took a manual count one hour later to see if his body was simply not taking them or just going through them that fast (24hours ). I would askwhat they are thinking. Also, being my dad’s child I held 50% of his DNA and they thought that if he had become refractory that my plateletes he may not reject…just a thought and something we looked into. He was not refractory afterall, but it was very scary till the transfusions took…I had asked at what point did a person stop accepting transfusions, and they could not give me an answer since everyone is different, but when he was going for the transplant it was important to try and transfuse only when necessary, that meant when his platelets were under 10,000 and hemo was under 8- scary counts. After the transplant was no longer an option (dad did not go into remission) they transfused almost daily, and needed to since the inductive chemo did such a number on his counts. Hope this helps- will pray for you – Jen
(refractory means there is no response)

[sdrake]

Mary,

When my dad was in the hospital with Influenza A and pneumonia this winter he needed transfusions almost daily. It seemed they did little good. As he got better, the need for transfusions wasn’t so often. He still needs one every 1-2 weeks, but at least it isn’t every 1-2 days as it was when he was sick.

Shari

[Russ P.]

Hi Mary,
Shari’s comments makes one think that your doc’s theory of the fever burning up or using the RBCs is a plausible explanation. I pray that Mike will get his fever down very soon. Many prayers for you both – you’ve been through a lot.
Blessings,
Russ

[marlene]

Hi Mary,

Ilness and fevers can chew through RBCs and platelets. I’m not certain of the mechanism but illness will effect blood counts. They should rebound when things resolve. For John, it can take a while before we see them get back to his normal range.

Marlene

[Mary4Mike]

God bless everyone for the quick responses. We are waiting to see where his HGB is today as they gave him 2 more units yesterday. His fever is still not contained, but the doc said yesterday that it could take 3-4-5- days on the antibiotics. He is on 3 differents ones with the big gun of them all – vancomycin. This will be day number 4 on the drugs.

I will keep you all posted.

Russ, I will update tonight when I get home from the hospital.

Thank you all for the prayers and support.

[Mary4Mike]

Hi all,

Mike’s HGB this morning came in at 9.8. He is, however, still running a fever – 103. We will see what tomorrow brings.

[Mary4Mike]

Hi all,

Mike was discharged from the hospital today. His temperature is down and his HGB was at 9.8 again today. They sent him home with oral antibiotics.

Thanks again for the responses to the fever questions.

[Author]

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