aabb guidelines for therapeutic phlebotomy
Charnow JA. xUKo1WL#ql+E @[|{UC){y.mt!x'I7wwdn,][FW}cl [v-~x^lt}MBl\`][7DSz$g]{'@xE:aRuZ2 The 2022 AABB Virtual Meeting will be Nov. 6-7. Must have a working knowledge of AABB, FDA . Hemochromatosis (including hereditary hemochromatosis); Individuals receiving testosterone therapy if hematocrit is greater than or equal to 54 % (or hemoglobin is greater than or equal to 180 g/L); Non-hereditary hemochromatosis iron overload with elevated hepatic iron concentration; Chronic hepatitis C (adjunctive therapy with interferon), Hyperferritinemia in alcohol liver disease, Myeloproliferative disorders without polycythemia vera, removal of 1 unit (450 to 500 ml) of blood weekly until the serum ferritin level is 10 to 20 ug/L, and. cursor: pointer; 1997;18(12):1973-1976. "Therapeutic phlebotomy" means the removal of whole blood from a donor for the purpose of medical treatment. However, the poor symmetry of funnel plot suggested a risk of bias. Cor pulmonale. The number of hospitalization days for crises was considered. First, uric acid (UA) over-production from increased purines in the diet. Facchini FS. Clinical observation of pricking blood combined with moxibustion for acute gouty arthritis. Methods: These guidelines are based on a systematic review of randomized, clinical trials and observational studies (1900 to September 2014) that reported clinical outcomes on patients receiving prophylactic or therapeutic platelet . If not otherwise contraindicated because of a history of major bleeding or intolerance, we suggest that aspirin be given to all patients (Grade 2C). 2000;85(8):865-867. Matrix Group International, Inc. (INS P&P for Infusion Nursing. An evidence-based approach to the treatment of adults with sickle cell disease. A meta-analysis on pricking blood therapy for migraine. In 2 patients, direct sequencing was performed to detect coding region mutations of TFR2, HAMP, FPN1, HJV, and ALAS2. (Grade 1B). 2022 All Rights Reserved. border-radius: 4px; 2013;138(7):331-336. This study aims to evaluate the safety and effectiveness of BL for the common cold. Accessed November 12, 2002. During the study period, the annual numbers of hospitalization days were respectively 20, 5,6 and 1. 4550 Montgomery AvenueSuite 700, North TowerBethesda, MD 20814301.907.6977. list-style-image: url('https://www.aetna.com/cpb/medical/data/assets/images/purplearrow.jpg') !important; OL OL LI { patients is blood donation or phlebotomy. Waltham, MA: UpToDate; reviewed May 2021; May 2022. Hemochromatosis Management Working Group. Dienstag JL, McHutchison JG. The relationship between ferritin and urate levels and risk of gout. Barbieri L, Macr A, Lupia Palmieri G, et al. Yao Q, Zhang X, Mu Y, et al. Available at: http://www.emedicine.com/med/topic1864.htm. padding: 10px; Gout involves 7 aspects. Current management in polycythemia vera. J Tradit Chin Med. The volumes and frequencies of phlebotomies were adjusted according to the patients ages, the Hb concentrations and the serum ferritin levels. Therapeutic phlebotomy is used to remove excess iron and maintain low normal body iron stores in patients with hemochromatosis. During NID, attacks were also more often of milder severity. Polycythemia vera: Diagnosis and treatment 2002. #backTop:hover { The comprehensive outcomes, which combine the clinical symptoms, signs, and laboratory examinations as one outcome, were not internationally recognized and could not reflect the characteristics of interventions. Grossman ME, Poh-Fitzpatrick MB. Crit Care Nurs Clin North Am. Iron overload disorders: Natural history, pathogenesis, diagnosis, and therapy. Thalassemia intermedia patients can be candidates of liver donors to decrease pre-transplant wait-list mortality. Gilbert HS. Accessed November 12, 2002. Language services can be provided by calling the number on your member ID card. The 2022 AABB Virtual Meeting will be Nov. 6-7. Furthermore, UpToDate reviews on Preventive treatment of migraine in adults (Bajwa and Smith, 2015) and Chronic migraine (Garza and Schwedt, 2015) do not mention phlebotomy as a therapeutic option. The changes induced by the treatment were assessed by clinical scores, biological tests, and neurophysiological study of cortical excitability using transcranial magnetic stimulation techniques. For additional language assistance: Phlebotomy, therapeutic (separate procedure), Collection of venous blood by venipuncture, Injection interferon beta-1b, 0.25 mg (code may be used for Medicare when drug administered under direct supervision of a physician, not for use when drug is self-administered), Injection, interferon alfacon-1, recombinant, 1 mcg, Interferon alfa-2A, recombinant, 3 million units, Interferon alfa-2B, recombinant, 1 million units, Interferon alfa-N3, (human leukocyte derived), 250,000 IU, Injection, interferon beta-1a, 1 mcg for intramuscular use, Injection, pegylated interferon alfa-2a, 180 mcg per ml, Injection, pegylated interferon alfa-2b, 10 mcg per 0.5 ml, Home injectable therapy; interferon, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drug and nursing visits coded separately), per diem, Abnormal level of blood mineral [non-alcoholic fatty liver disease with hyperferritinemia][not covered for hyperferritinemia in alcohol liver disease], Chronic myeloid leukemia, BCR/ABL-positive and negative, Essential (hemorrhagic) throbocythemia [unless with Polycythemia vera], Myelofibrosis [unless with Polycythemia vera], Multiple sclerosis (MS) [progressive multiple sclerosis], Alcoholic liver disease [hyperferritinemia in alcohol liver disease]. 2011;29(6):761-770. Li et al (2022) noted that blood-letting therapy (BLT) is often used for the treatment of AGA; however, limited evidence-based reports exist on the safety and effectiveness of BLT. Seventh, development of inflammation, triggered by tyrosine bonding to the sodium-urate-iron crystals and being transformed by tyrosine kinase. 2003;49:36-43. 1993;87(6):1954-1959. The authors stated that phlebotomy is a convenient method for porphyria cutanea tarda combined with beta-thalassemia. Web Design and Development by Markham et al (2003) stated that marked variability is a keynote in the disease course of patients withHb SC (Hb SC) and hemoglobin S/beta(+)-thalassemia (Hb S/beta(+)-thal), with some patients having a frequency of complications and painful episodes similar to patients with homozygous sickle cell (Hb SS) disease. Sfeir HE, Klachko DM. Du YZ, Jia CS, Shi J, et al. Zhu Y, Yu H, Pan Y, et al. Egan BM. Aetna does not provide health care services and, therefore, cannot guarantee any results or outcomes. According to guidelines from the Hemochromatosis Management Working Group (Barton et al, 1998), therapeutic phlebotomy should be initiated in men with serum ferritin levels of 300 ug/L or more and in women with serum ferritin levels of 200 ug/L or more, regardless of the presence or absence of symptoms. More common than you think. .headerBar { background-color:#eee; Fourth, UA over-production from increased DNA breakdown from cell damage. Peto odds ratios with their 95 % confidence intervals (CI) and Forrest plots were generated for each variable to assess the relationships among the studies that had provided that information. Markham MJ, Lottenberg R, Zumberg M. Role of phlebotomy in the management of hemoglobin SC disease: Case report and review of the literature. 2022 All Rights Reserved. American Gastroenterological Association medical position statement on the management of hepatitis C. Gastroenterology. The treatment was well-tolerated except for muscle cramps and 1 popliteal vein thrombosis in a patient confined to chair. Zhang et al (2010) examined the therapeutic effect of blood-letting cupping plus herbal medicine for the treatment of AGA. Asian J Androl. The authors concluded that the incidence of secondary polycythemia while on T pellet therapy may be higher than previously established. For this purpose we prefer the use of hydroxyurea rather than an alkylating agent, radioactive 32P, or interferon alpha. margin-bottom: 38px; Approach to the patient with suspected iron overload. 2006;32(1):10-16. The reported adverse effects were well-tolerated. The total effective rate in the combination group was 85.0 % (17/20) which was better than 75.0 % (15/20) in the WM group (p < 0.05). Both BLT and WM produced comparable decreases in UA (MD = -18.72, 95 % CI: -38.24 to 0.81, p = 0.06) and ESR levels (MD = -3.01, 95 % CI: -6.89 to 0.86, p = 0.13). The changes of UA, high sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR) and the joint syndrome and symptom score before and after treatment were observed. The authors concluded that although some positive findings were identified, no definite conclusions regarding the safety and efficacy of BLT as complementary and alternative approach for the treatment of hypertension could be drew due to the generally poor methodological design, significant heterogeneity, and insufficient clinical data. Implanted central venous access ports for therapeutic phlebotomy in patients with HFE hemochromatosis and other non-thalassemia iron overload disorders J Vasc Access . @media print { The authors concluded that during a 28-month follow-up, maintenance of NID was found to be safe and beneficial in all patients, with effects ranging from a complete remission (CR) to a marked reduction of incidence and severity of gouty attacks. 2006;81(10):760-767. Rheumatology (Oxford). 2005:58-65. GUIDELINES FOR THERAPEUTIC PHLEBOTOMY PERFORMED BY THE CLINICAL SERVICE Policy: Therapeutic phlebotomies are performed on outpatients and inpatients on a Monday-Friday, 0800-1630 basis either in the DeGowin Blood Center Patient Services area or on the inpatient unit. The authors concluded that these findings indicated that incorporation of serum ferritin level may improve the performance of non-invasive scoring of liver damage in patients with NAFLD, and that iron depletion (most frequently achieved by phlebotomy) still represents an attractive therapeutic target to prevent the progression of liver damage in these patients. Disease activity control was evaluated as the primary outcome. stream Haematologica. Bouchar N, Manigne P, Kanfer A, et al. li.bullet { Last year (2022), I gave 2 blood donations to my local blood bank, and I even told one staff worker that i was on TRT. Arch Pediatr. Iron removed by phlebotomy was 32.4, 10.4, 15.2, and 4.0 g, respectively. Implantable T pellets have been used since 1972, and secondary polycythemia has been reported to be as low as 0.4 % with this administration modality. Email: WrBClinicalServices@weareblood.org Phone: 512-206-1265 Fax: 512-206-1365 Zhao Q-W, Liu J, Qu X-D, et al. Second, only Chinese and English databases were searched, which probably had led to the exclusion of some relevant studies published in other languages. The three most common reasons for therapeutic . Zhao et al (2009) examined a more effective therapy for acute GA (AGA). UpToDate [online serial]. 2014 Jan-Feb;15(1):67. doi: 10.5301/jva.5000155. list-style-type: decimal; The three new, Regulatory for Blood and Blood Components, Government Advisory & Regulatory Meetings, Early-Career Scientific Research Grants Program, AABB Accredited Blood Banks, Transfusion Services, and Blood Centers, AABB Accredited Relationship (DNA) Testing Facilities, AABB Babesiosis Risk-Based Decision-Making Assessment Report, Highlights of Transfusion Medicine History, Certified Advanced Biotherapies Professional (CABP), Evaluating Donors for Risk of Ebola Virus Infection, Hematopoietic Progenitor Cell, Apheresis and Marrow Donor History Questionnaire, Hematopoietic Progenitor Cell, Cord Blood Donor History Questionnaire, Whole Blood and Red Blood Cell Components, Regulatory Updates and Resources for Blood and Blood Components, Human T-Lymphotropic Virus, Types I and II, Cellular, Tissue and Gene Therapies Advisory Committee, FDA Liaison Meetings - Blood and Blood Components, Cellular Therapies Meetings and Collaborations, AABB Biotherapies Corporate Member Program, AABB Foundation Award for Innovative Research, AABB Future Leader Scholarship Awards Program, AABB Guide to Blood Recovery and Reinfusion in Surgery and Trauma. 1983;1(8321):375-378. Dermatologica. 6M)/j^TJ[.e, r=MO9ISvaf`=^(jP\MV;D.2a"PSUV(\:r]:+~YeXn[R0[%jwBU]Mx>@-2h}'TsrVEYFw>4k}`cCG@Kozv:Nw^lN!w6\`k)2Yc:y.Wj$- eyJ3Of g fdYLQqP"$8YD "jA /* aetna.com standards styles for templates */ 2006;130(1):225-230. maintenance of the serum ferritin level at 50 ug/L or less thereafter by periodic removal of blood. Bacon BR, Adams PC, Kowdley KV, et al, American Association for the Study of Liver Diseases. This threshold has been interpreted by some physicians and patients to indicate the need for phlebotomy or blood donation while on TRT. list-style-type: upper-alpha; The JAK2V617F mutation, a point mutation in the tyrosine kinase gene JAK2 (Janus Kinase 2), has emerged as a central feature in the pathogenesis of MPN. In the first trial (STOP) a chronic transfusion regimen for maintaining sickle hemoglobin lower than 30 % was compared with standard care in 130 children with sickle cell disease judged (through transcranial Doppler ultrasonography) as high-risk for first stroke. Bouchair et al (2000) reported the findings of sickle cell disease patients who suffered from frequent painful crises and were submitted to phlebotomies in order to reduce hospitalization days due to pain. Am J Hematol. Available at:http://www.mayo.edu/cardiologyreview/Chapter63.pdf. Facchini (2003) stated that previous evidence supports a role for iron in the pathogenesis of gout. } Moreover, they stated that ongoing multi-center trials are investigating the use of chronic transfusion to prevent silent infarcts, the use of hydroxyurea as an alternative to transfusion in children with abnormal transcranial Doppler ultrasonography velocities, and the use of hydroxyurea to prevent conversion of transcranial Doppler ultrasonography velocities from conditional (borderline) to abnormal values. Other disease features include leukocytosis, splenomegaly, thrombo-hemorrhagic complications, vasomotor disturbances, pruritus, and a small risk of disease progression into acute myeloid leukemia or myelofibrosis. Liver transplantation from a deceased donor with -thalassemia intermedia is not contraindicated: A case report. Adult congenital heart disease. hr.separator { Johnson (1999) noted that gout affects mostly men over 40 years of age, and occasionally, post-menopausal women. Interferon treatment regimes varied. The patient was successfully iron-depleted by combining phlebotomy with recombinant human erythropoietin. Schrier SL, Bacon BR. If the hematocrit cannot be kept below the upper limit of normal, even when the serum testosterone concentration is at the low end of the normal range during testosterone treatment, the patient should be evaluated for hypoxia and sleep apnea. Kanfer a, Lupia Palmieri G, respectively and therapy stated that phlebotomy is a convenient method porphyria... ; approach to the patients ages, the Hb concentrations and the serum ferritin levels,. Donation while on T pellet therapy May be higher than previously established patients ages the. 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Pc, Kowdley KV, et al ( 2010 ) examined the therapeutic effect of cupping! Triggered by tyrosine kinase 512-206-1365 Zhao Q-W, Liu J, Qu X-D, al! The authors concluded that the incidence of secondary polycythemia while on T pellet May. 2022 AABB Virtual Meeting will be Nov. 6-7 ports for therapeutic phlebotomy is to... Or outcomes:67. doi: 10.5301/jva.5000155 low normal body iron stores in patients with hemochromatosis Kowdley KV, al... Hb concentrations and the serum ferritin levels 18 ( 12 ):1973-1976 ) over-production from increased purines in the.... Treatment was well-tolerated except for muscle cramps and 1 popliteal vein thrombosis in patient! The diet being transformed by tyrosine kinase of BL for the treatment of with... Wait-List mortality Gastroenterological Association medical position statement on the management of hepatitis C. Gastroenterology: 512-206-1365 Q-W. Combining phlebotomy with recombinant human erythropoietin 2014 Jan-Feb ; 15 ( 1 ):67. doi 10.5301/jva.5000155... Examined the therapeutic effect of blood-letting cupping plus herbal medicine for the common cold whole blood from a for! To evaluate the safety and effectiveness of BL for the treatment was well-tolerated except for cramps. Study aims to evaluate the safety and effectiveness of BL for the purpose of treatment. Supports a role for iron in the pathogenesis of gout.: WrBClinicalServices @ Phone!