Patients treated with upfront TXA and cryoprecipitate during CRS required less RBC transfusion than those treated with the standard protocol of early FFP.
SummaryThe outcomes of 55 consecutive haemato-oncology patients admitted to the intensive care unit (ICU) were retrospectively analysed. Twenty-eight patients were admitted following haemopoietic stem cell transplantation (HSCT). Thirty-nine patients were admitted with respiratory failure, and all patients required respiratory support. Seventeen patients survived to be discharged from ICU, with an actuarial 1-year survival of 18%. Overall survival between patients who received intensive chemotherapy and those who underwent allogeneic HSCT was not significantly different (19% vs. 10%, P ¼ 0AE19). None of the nine myeloablative HSCT recipients survived (median survival: 9 d). Six of the 15 reduced-intensity conditioned HSCT recipients survived beyond 1 year (median survival: 1050 d, range: 438-1437).
A 71-year-old male presented with signs and symptoms of an acute radiation burn, 6 months after a single fraction of palliative radiotherapy.He had a history of peripheral T-cell lymphoma, not otherwise specified, with bilateral apical lung nodules, multiple liver nodules and T1 vertebral body involvement. At the time of diagnosis, he complained of pain over T1 and received a single fraction of radiotherapy (eight Gray) to this area. This resulted in a good symptomatic improvement and he experienced neither adverse signs nor symptoms from the radiotherapy. Unfortunately, his disease progressed through two cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone) chemotherapy. Treatment was, thereafter, changed to gemcitabine and prednisolone (Gem-P protocol: gemcitabine 1 g/m 2 days 1, 8 and 15; prednisolone 1 g days 1-5; cisplatin 100 mg/m 2 day 15) with cisplatin added following the second cycle of treatment. This resulted in a regression of his lymphoma.Fourteen days after the addition of cisplatin, he presented with a two-day history of progressive severe upper back pain and examination revealed a new square erythematous area over T1 (left). Magnetic resonance imaging (MRI) showed a well-demarked area of muscle necrosis at the site of previous radiotherapy (right, coronal MRI). His presentation had the appearance of an acute radiation burn. It occurred 6 months after a single fraction of radiotherapy and represents a result of radiation recall.Radiation recall, also known as radiation recall dermatitis, is an inflammatory skin reaction at sites of previous radiation exposure in response to drug administration. The underlying pathological mechanism is not understood and there are no identified drug characteristics that precipitate this reaction. This rare phenomenon has been reported most commonly following administration of anthracycline chemotherapeutic agents, but has also been reported after exposure to antibiotics.
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