Protocols - Hemorio

CML - Subjects with symptoms related to the hyperviscosity (auditive and visual losses) due to the
hyperleukocytosis, must be treated with plasmapheresis.
Polycythemia Vera – PHLEBOTOMY – the hematocrit must be normalized and kept at 42% for women
and 45% for men. In young individuals, with a good cardiovascular state, start the treatment with a
removal of 450 ml of blood every 2 days.
In the elderly, or with cardiovascular complications, small-volume phlebotomies must be performed (200-
300 ml), twice a week, in order to avoid hemodynamics instability and hypotension. In many sick people,
the disease may be controlled for years with some phlebotomies by year.
13 – MULTIPLE MYELOMA, LYMPHOMAS AND OTHER HEMATOLOGICAL NEOPLASIAS
Transfuse de-leukocytated red blood cells prophylactically
14 – HEMOTHERAPIC CONDUCT AT WALDENSTRON MACROGLOBULINEMIA AND SOME CASES
OF MULTIPLE MYELOMA
Subjects with symptoms related to hyperviscosity, or with a neurological setting must be treated with
plasmapheresis.
15 – HEMOTHERAPIC CONDUCT AT THE BONE MARROW TRANSPLANTATION
The transfusional support must aim at the maintenance of Hb above 8g/dL and platelets above 10,000/µL.
All hemocomponents must be irradiated and filtrated.
SUBJECTS IN AN AUTOLOGOUS-TMO PROGRAM
AT THE MOBILIZATION PHASE
- Transfuse de-leukocytated blood prophylactically.
- A week before the collection, and until the conclusion of the last collection, transfuse irradiated blood.
- Transfuse phenotyped blood for the antigens Rh and Kell (Rh1, Rh2, Rh3, Rh4, K1).
AFTER THE CONDITIONING
- Transfuse de-leukocytated blood prophylactically.
- Transfuse irradiated blood up to six (6) months after the infusion date of the stem cells.
- Transfuse phenotyped blood for the antigens Rh and Kell (Rh1, Rh2, Rh3, Rh4, K1).
SUBJECTS IN AN ALLOGENIC-TMO PROGRAM
- Transfuse de-leukocytated blood prophylactically.
- Transfuse irradiated blood up to twelve (12) months after the infusion date of the stem cells.
- Transfuse phenotyped blood for the antigens Rh and Kell (Rh1, Rh2, Rh3, Rh4, K1).
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