12th Congress of the European Hematology ... - Haematologica

12 th Congress of the European Hematology Association
while 19(26.8%) did not. 4(5.6%) patients developed venous or arterial
thrombosis instead of bleeding. 1 had normal clotting profile while the
rest had low FV and prolonged PT and aPTT (2 of which also had LA
activity). Among those who bled, 81.4% achieved haemostasis and 20%
died from haemorrhage. Univariate analysis showed that bleeding manifestation
was significantly associated with low FV, prolonged PT and
aPTT, but not with age, gender, level and duration of inhibitor. Mortality
from haemorrhage was only significantly associated with haemostatic
failure and not with other characteristics. Hence, appropriate therapy
must be started promptly for bleeding patients to rapidly achieve
haemostasis and decrease mortality. Table 1 showed the success rates
of various treatment. The most effective therapy was immunosuppression
and immunoadsorption. Platelet transfusion also helped as platelets
contain 20% of the body’s FV which might be shielded from the inihibitor.
In 15.5% of the cases, the condition was self-limiting and resolve
without treatment. Conclusions. Spontaneous FV autoantibody development
is unpredictable and often unavoidable, with variable manifestation
and course. It can be life-threatening in cases with bleeding complications.
Treatment should be instituted as soon as possible in such cases
to avoid mortality.
0972
COMPREHENSIVE VIEW OF THE HAEMOPOIETIC STEM CELL PROGRAM:
THE PRE-TRANSPLANT PHASE
F.J Marquez, I. Espigado, M. Carmona, JM. Perez Hurtado, R. Moya,
R. Parody
Hospital Universitario Virgen Del Rocio, SEVILLA, Spain
Background . The pre-transplant phase of the Stem Cell Transplantation
(SCT) may influence survival and quality of life, and efficiency of
health expenses. However, there is a lack of published data on it. Aims.
To analyze the pre-transplant stem cell program phase of a tertiary Institution,
in order to identify pre-transplant variables influencing relevant
clinical outcomes. Patient and methods. Pre-transplant data on 172 consecutive
patients evaluated by the SCT Committee of a tertiary Institution
(Paediatric and adult programs) were prospectively collected and analyzed.
Period: April 21th 2005, through December, 31th 2006. Variables
were codified in a computer software tool developed as support for the
management of SCT programme (Gesthronica ® ) allowing us to register
social-demographic, and clinical variables. Statistical analysis was performed
with the SPSS ® statistical package. Comparison between groups
of patients by type of SCT, disease characteristic and referring centre
were performed (Kruskal-Wallis Test). Results. One hundred and seventy
two consecutive patients entered the study: 152 were referred for the
first time -acute leukemias (56), lymphomas (43), plasma cell disorders
(22), myelodysplastic syndromes (9), chronic myelogenous leukemias
(6), inherited disorders (4), chronic lymphocytic leukemias (3), solid
tumours (3%), aplastic anemias (3), hemoglobinopathy (2), non clear
diagnosis established (1). Additionally, 20 patients, previously treated
with SCT, were re-considered as candidates to SCT because of relapse
(10), graft failure (8) secondary malignancy (1) or multiple-graft program
(1). One hundred and thirty nine (80.8%) were accepted for transplant
while 25 (14.5%) were not, and 8 (4.7%) were delayed because of additional
courses of treatment required before SCT. Scheduled procedures
were autologous SCT (75), allogeneic STC (58) and DLI (6). At the time
of the analysis, 83 (59.7%) patients had already been treated, 24 (17.3%)
were still awaiting SCT and 32 (23%) were secondarily excluded from
the SCT program because of: chemotherapy related death (11; 34%),
poor stem cell mobilization (7; 22%) patient’s refusal (5; 15,%),
relapse/progression (3; 9%), acquired co-morbidity (2; 6%), donor’s
refusal (2; 6%) and other reasons (2; 6%). Median time between inclusion
in the program and transplant was 3,81 months (range 0,27-13,43),
being 5,7 months (p