This method offers better results in less time than traditional phlebotomy. EA with rHuEPO is an effective therapeutic alternative for patients with HH.

The administration of intravenous immunoglobulin (IVIG) in immune and autoimmune diseases led us to use this agent to ameliorate or prevent the consequences of non-ABO incompatible transfusions in patients who need this form of therapy. IVIG (400 mg/kg/day) was infused within 24 h of transfusion in 5 patients with: (1) intestinal angiodysplasia, gastrointestinal bleeding, and anti-Kpb; (2) paroxysmal nocturnal hemoglobinuria, anti-c, anti E, anti Fyb, anti-K and autoantibodies; (3) lymphoma and autoimmune hemolytic anemia (AIHA); (4) systemic lupus erythematosus (SLE), AIHA, and anti-D, and (5) SLE and AHIA. A sustained increase in hematocrit was noted and no transfusion reaction developed in any of the cases. A single dose of pretransfusion IVIG may therefore be a useful therapeutic alternative in patients for whom no compatible blood is available. Patients with severe anemia, allo- and autoantibodies, either showing hemolysis in their pathophysiology or not, cause a serious problem in any transfusion center, especially when dealing with emergencies. In order to reduce the risks of incompatible transfusions, different modalities have previously been attempted, all with poor results. In 1989 we reported the successful use of pretransfusional high-dose intravenous immunoglobulin (IVIG) in a patient with gastrointestinal bleeding and anti-Kpb. The transfusion of incompatible red blood cells improved the anemia and allowed the exploratory laparotomy to take place. A protocol was then developed based on this case administering pretransfusion IVIG in high doses for patients for whom no compatible blood (non-ABO) is available.

Background and Objectives: The purposes of this study were to evaluate the tolerance, efficacy and safety of isovolemic erythrocytapheresis (EA) in nonanemic patients with hereditary hemochromatosis (HH), and to assess the usefulness of recombinant human erythropoietin (rHuEPO) associated with EA to reduce treatment duration. Materials and Methods: In 10 asymptomatic patients with serum ferritin >400 μg/l, transferrin saturation >50%, and GPT elevation, EA with rHuEPO and folic acid was performed. Results: Red cell indices, serum ferritin, and other iron metabolism parameters (serum iron, transferrin, and transferrin saturation); GPT and other laboratory data were considerably improved. Conclusion: This method offers better results in less time than traditional phlebotomy. EA with rHuEPO is an effective therapeutic alternative for patients with HH.

Six patients were included in a trial involving the SC administration of rIFN{alfa)-2b (Schering Plough) at a dose of 5 {multi} 10(6) IU daily, 5 days a week and continued while a clinical response was observed. All patients had previously received between 3 to 5 salvage chemotherapy programs without a disease free interval prior to the administration of rIFN{ALFA}-2b. Two patients had extranodal disease (lung, bone) and all 6 patients had "B" symptoms. Five of the patients showed stable disease, for a period of 3 to 12 months. One patient with recurrent HD obtained partial remission which lasted 26 months, at which time he developed autoimmune hemolytic anemia. Toxicities observed were mild and consisted of a flulike syndrome, supraventricular tachycardia and mild increase in transaminases. The quality of life improved while on rIFN{ALFA}-2b therapy, contrasting with the toxicity of the aggressive chemotherapy regimens previously administered which required frequent hospitalizations. This preliminary experience suggests that the role of rIFN{ALFA}-2b in the treatment of HD requires more study.