[mowgli18]

when to get blood transfusion

by mowgli18 on Tue May 24, 2011 12:53 pm

I guess this is a question for a doc:

I have gone through 2-three week cycles of Velcade/dex/Revlimid and had to have two blood transfusions because of anemia. The problem really is that I am working between two hospitals now -- one major medical center (Dartmouth-Hitchcock in New Hampshire) where my main specialist is and one in Rutland, Vermont (much closer) where I get most of the infusions.

The transfusions were done when my RGB was 8.2 the first time and 8.8 the second time. The first time I felt very weak and tired so I guess I needed it but the second time I was actually feeling better than I had to date so I was surprised by the lower count (it had gone down from just above 10).

When I went back to see my specialist she said that if I felt okay I might want to wait for a transfusion until my counts were around 7 or 7.5. If I do this (which would limit the amount of transfusions -- a good thing for my time, my job, and my life) will it take that much longer to recuperate or should I play it safe and do it earlier when the counts start to drop before they go to low and hence get a higher RGB count (the second count was up above 11 while the first was in the low 10s after the transfusion)?

any thoughts would be welcome.

Peri

[Dr. David Vesole]

Re: when to get blood transfusion

by Dr. David Vesole on Wed May 25, 2011 3:21 pm

Our institution uses a parameter of 7 g as our threshold for initiating transfusion support. However, this depends on if the patient is symptomatic or has other medical problems which may warrant maintaining a higher hemoglobin level (e.g. coronary artery disease).

As your myeloma comes under control with RVD, your hemoglobin should increase. In the interim, it may be worthwhile to consider the red blood cell stimulating agents to avoid transfusions for someone with symptomatic, chemotherapy associated anemia (i.e. Procrit, Epogen or Aranesp).