Treatment Of Hemolytic Anemia Research Articles

Hemolytic anemia in emergency and intensive care medicine

Hemolytic anemia (HA) is caused by premature destruction or degradation of red blood cells (RBC). Low hemoglobin, suppressed haptoglobin, reticulocytosis as well as an elevation of lactate dehydrogenase and bilirubin are common laboratory findings in HA. Intracorpuscular HA due to defects of the RBC themselves are distinguished from extracorpuscular HA due to external factors. Severity of symptoms such as fatigue and dyspnea depend on the degree of anemia. For optimal treatment of HA, adetailed evaluation of the patient history (including hereditary RBC defects, Bsymptoms and travel history) is necessary. Additional diagnostics (hematological diagnostics, infectious disease diagnostics, immunological diagnostics, computed tomography [CT] scan) should be performed according to the patient's individual requirements. Treatment of HA depends on the etiology. If HA is immune-mediated, immunosuppressive therapy is indicated, whereas HA due to infections usually improves after adequate anti-infective therapy. Anti-infective therapy should also be considered in patients with sickle cell disease who present with severe HA. In general, HA can be treated effectively in most cases.

Real-World Experience of Voxelotor for the Management of Complications in Sickle Cell Disease

Background: Sickle cell disease (SCD) is an inherited systemic disorder characterized by chronic hemolytic anemia and recurrent vaso-occlusion, which can lead to acute and chronic complications, disability, and early mortality. Patients with SCD are hospitalized frequently and most commonly for vaso-occlusive crises (VOCs). Furthermore, most will require a blood transfusion for prevention or acute management of complications, with >90% of adults receiving ≥1 transfusion in their lifetime. Voxelotor (Oxbryta ®) tablets are indicated for treatment of SCD in adults and adolescents aged ≥12 years. Emerging evidence shows that voxelotor, an oral, once-daily sickle hemoglobin-polymerization inhibitor, may improve the clinical symptoms of SCD and reduce VOC rates as well as the need for transfusions. This study sought to assess the real-world impact of voxelotor treatment on the rates and management of SCD-related complications.Methods: Medical and pharmacy claims data for patients aged ≥12 years with SCD who initiated voxelotor therapy between November 2019 and March 2021 were procured from the Symphony Health claims database. Patients with ≥1 year's data before the index date (date of the first voxelotor claim for each patient) were included in the analyses. Baseline demographic and clinical characteristics were summarized using descriptive and inferential statistics. Annualized rates per patient-year (PPY) for transfusions, VOCs, VOC-related and all-cause hospitalizations, before and after voxelotor initiation were compared. Hemoglobin (Hb) responses were evaluated for a subset of patients for whom Hb lab data were available (≥1 Hb value recorded 30 days before initiating voxelotor and ≥1 Hb value recorded after the index date).Results: As of March 2021, a total of 2695 eligible patients from the Symphony Health claims database were included in the analysis (mean age: 34.6 years; 60% female); 915 patients (34%) had ≥1 VOC in the 3 months before initiating voxelotor. Among the subset of patients with pre- and post-voxelotor Hb measurements (n=63), mean (95% CI) Hb was 7.9 (7.5-8.2) g/dL at baseline, and final Hb was 8.9 (8.4-9.4) g/dL after voxelotor initiation. Most patients (38/63; 60.3%) achieved a Hb increase of >1 g/dL at any time point during follow-up. In 357 patients who received ≥1 transfusion in the year before voxelotor initiation, the mean (95% CI) transfusion rate decreased by 43%, from 3.2 (2.8-3.7) to 1.8 (1.4-2.3) PPY (P<0.001) (Table). In 40 patients receiving chronic transfusions (≥8), the mean (95% CI) transfusion rate decreased by 34%, from 9.8 (8.3-11.4) to 6.5 (4.4-8.5) PPY (P=0.007). Among patients who had ≥1 VOC in the 3 months before initiating voxelotor, the mean (95% CI) annualized VOC rate decreased by 22%, from 10.9 (10.4-11.5) to 8.5 (7.8-9.3) (P<0.001); and the mean (95% CI) rate of VOC-related hospitalizations decreased by 32%, from 7.3 (6.9-7.7) to 5.0 (4.4-5.6) (P<0.001). In 636 patients who were previously hospitalized in the 3 months before voxelotor initiation, the mean (95% CI) all-cause hospitalization rate reduced by 36%, from 7.5 (7.1-7.9) to 4.8 (4.3-5.3) (P<0.001) after treatment. Limitations of this analysis include the possibility of secular trend biases or general regression to the mean.Conclusions: In real-world practice, voxelotor increased Hb by ≥1 g/dL, consistent with the HOPE trial. Data suggest statistically significant reductions in transfusions, VOCs, all-cause and VOC-related hospitalizations after voxelotor use. This real-world evidence provides additional support for the use of voxelotor in the treatment of hemolytic anemia and the management of its associated complications. [Display omitted] DisclosuresShah: Novartis: Research Funding, Speakers Bureau; Emmaus: Consultancy; Alexion: Speakers Bureau; GLG: Consultancy; GBT: Consultancy, Research Funding, Speakers Bureau; Guidepoint Global: Consultancy; Bluebird Bio: Consultancy; CSL Behring: Consultancy. Lipato: Global Blood Therapeutics: Speakers Bureau. Alvarez: Forma Therapeutics: Membership on an entity's Board of Directors or advisory committees; GBT: Membership on an entity's Board of Directors or advisory committees. Delea: Global Blood Therapeutics: Research Funding; Amgen: Research Funding; Bristol-Myers Squibb: Research Funding; Celgene: Research Funding; Takeda: Research Funding; Merck: Research Funding; Policy Analysis Inc.: Current Employment; AbbVie: Research Funding; Novartis: Research Funding; Regeneron: Research Funding; Sanofi: Research Funding. Lonshteyn: Policy Analysis Inc. (PAI): Current Employment; Global Blood Therapeutics: Research Funding; Novartis: Research Funding. Weycker: Policy Analysis Inc. (PAI): Current Employment, Current equity holder in publicly-traded company; Global Blood Therapeutics: Research Funding; Novartis: Research Funding. Nguyen: Global Blood Therapeutics: Current Employment, Current equity holder in publicly-traded company. Beaubrun: Global Blood Therapeutics: Current Employment, Current equity holder in publicly-traded company. Agodoa: Global Blood Therapeutics: Current Employment, Current equity holder in publicly-traded company.

Understanding Radix Angelica sinensis Blood Replenishing mechanisms on Blood Deficiency Rats Based on a UPLC-Q/TOF-MS Metabolomics and Network Pharmacology

Radix Angelica sinensis (RAS) is a famous Chinese medicine with hematinic effects and has been applied for the treatment of blood deficiency syndrome for many years. Previous studies have indicated that RAS has beneficial effects in the treatment of hemolytic anemia. The hemolytic anemia/blood deficiency syndrome is a common syndrome that is often presented in most traditional Chinese medicine (TCM) clinics. Based on routine blood indicators, metabolomics analysis was conducted to investigate the mechanism of RAS in the treatment of hemolytic anemia. Multivariate and univariate statistical analysis were used to identify potential biomarkers in the serum. On administering RAS to the haemololitic anaemic rat, the levels of WBC, RBC, HGB, and PLT in AG tended to shift toward that of the control group. Additionally, all the 26 metabolites such as cholic acid, succinic acid and orotate which are regulated by blood deficiency appeared normal through the five metabolic pathways, such as linoleic acid metabolism, alanine, aspartic acid and glutamate metabolism, pyrimidine metabolism, arginine and proline metabolism. Thus, three metabolic pathways predicted by the network pharmacology were consistent with the metabolism pathway of Angelica sinensis: linoleic acid metabolism, arginine and proline metabolism, tryptophan metabolism. The integrated metabolomics and network pharmacology comprehensively improved the understanding of the physiological and metabolic state of an organism. The possible hematopoietic effects and underlying mechanism of action on hemolytic anemia rats after lavage with RAS water extracts, could potentially be elucidated by combining pharmacology with untargeted metabolomics. These pointed out the significance of metabolomics as a valuable tool for studying the essence of Chinese medicine’s syndrome theory and the mechanism of RAS under anti-blood deficiency syndrome.

O exame de sangue e a anemia hemolítica em cães e gatos – revisão

Precise diagnosis and treatment of hemolytic anemia is a challenge to veterinarians. Toxins, infectious, and autoimmune diseases can cause hemolytic anemia in dogs and cats. Blood smears provide information that can assist in the diagnosis and help to identify the possible etiology of the condition. In many veterinary clinics, the introduction of automated blood cell count has led to abandoning the routine of evaluating blood smears. This article reviews the citologic characteristics of different types of hemolytic anemias in dogs and cats.

Real-World Effectiveness of Voxelotor for Treating Sickle Cell Disease in the US

Real-World Effectiveness of Voxelotor for Treating Sickle Cell Disease in the US

The aqueous extract of Allium saralicum R.M. Fritsch effectively treat induced anemia: experimental study on Wistar rats

There are many medicinal plants in traditional medicine which are used to prevent, control, and treat anemia. One of these plants is Allium saralicum R.M. Fritsch. The purpose of our research was to investigate the effect of aqueous extract of A. saralicum leaf in the treatment of hemolytic anemia. In this study, 60 rats were used. Induction of hemolytic anemia was done by three injections of Phenylhydrazine in 50 animals. Then, the rats were divided into six subgroups, including negative healthy control, untreated negative control, and four groups receiving the A. saralicum at 25, 50, 100, and 200 mg/kg concentrations. At the end of day 15 of treatment, the animals of all groups were weight and then sacrificed. The blood, liver and spleen samples were drawn immediately to analyze the hematological, biochemical and histological parameters. All groups of A. saralicum (especially AS200) significantly (p ≤ 0.05) reduced the raised concentrations of Fe, ferritin, erythropoietin, ALP, AST, ALT, GGT, cholesterol, LDL, triglyceride, total and conjugated bilirubin, urea, and creatinine and increased the levels of body weight, HDL, total protein, albumin, WBC, lymphocyte, monocytes, platelet, RBC, Hb, PCV, MCV, MCH, and MCHC as compared to the untreated group. Also, A. saralicum at all doses prevented pathological changes in the liver and spleen. In conclusion, because of aqueous extract of A. saralicum leaf anti-anemic property, it can be used as a medical supplement or drug.

Discordant intrauterine transfusion in dichorionic twin pregnancy with Rh isoimmunization

Discordant intrauterine transfusion (IUT) in twin pregnancy with Rh isoimmunization is uncommon and complicated. We report a gravida 3, para 2 woman with a dichorionic diamniotic (DCDA) twin pregnancy and two fetuses received discordant transfusions. Middle cerebral artery peak systolic velocity (MCA-PSV) was used to evaluate the anemic degree in each foetus. IUT was performed 3 times in twin A and 4 times in twin B to reverse foetal anaemia. Transfusions were distinct due to the different tolerance to IUT, and the procedure could be continued in one foetus even if the other one underwent complications. Two male babies were born at 36 weeks of gestation and were given different treatments after birth. Twins were subsequently healthy after 2 years of follow up.The discordant IUT was due to the different tolerance to transfusion in the DCDA twins. Zygosity is important for the management and treatment of haemolytic anaemia in twin pregnancies.

Diagnosis and treatment of hemolytic anemia

Hemolytic anemia is defined as anemia due to a reduction of the RBC lifespan to less than the normal range of approximately 120 days. Patients with anemia and jaundice are often suspected to have hemolysis. Herein, different causes of hemolysis and the diagnostic algorithm are reviewed. Currently, there is no generic treatment for hemolytic anemia. Appropriate management of a patient with hemolytic anemia requires determination of the underlying cause. Treatments for the different causes of hemolytic anemia are also reviewed.

Effects of standardized stem bark extract of Mangifera indica L. in wistar rats with 2,4-dinitrophenylhydrazine-induced haemolytic anaemia

Background: The aqueous decoction of the stem back of Mangifera indica L. has been traditionally used for the treatment of various illnesses among them includes anaemia. Aims: The aim of this study was to investigate the anti-anaemic properties of standardized stem bark extract of M. indica in animals with 2,4-dinitrophenylhydrazine-induced haemolytic anaemia. Methods and Material: An in vivo animal model was used in this experiment. 2,4-dinitrophenylhydrazine was used to induce haemolysis and treatment was done with three different concentrations (25, 50, and 100 mg/ kg b.wt) of the plant extract. Astifer® was used as a positive control. Haematological parameters such as PCV, HGb concentration, and TLC were performed and to ascertain the level of haemolysis. GC-MS was used determine the present of phytoconstituents within the crude extract. Results: PCV and HGb concentration increased significantly (p 0.05) effect was observed at a dose of 25 mg/kg b.wt. TLC was decreased significantly (p 0.05) effect was observed at a dose of 25 and 50 mg/kg b.wt respectively. GC-MS analysis revealed presence of 15 compounds viz: 2,2-Dimethoxybutane, N-Acetyl-Alpha-D-glucosamine, 1,2-Benzenediol, Phenol, 2,4-bis(1,1dimethylethyl)-, Vitamin E, Pentadecanoic acid, 13-methyl-, methyl ester, 2-Ethylacridine, Benzofuran-6-ol-3-one, 2-(4ethoxycarbonyl)benzylidene-, 9-Octadecanoic acid, (E)-, 2,4,6-Cycloheptatrien-1-one, 3,5-bis-trimethylsilyl-, and Benzo[h]quinoline,2,4-dimethyl-. Conclusion: The results of our present finding suggest the significant anti-anaemic properties of standardized stem bark extract of Mangefera indica L. This finding highlights the potentials of the extract and M. indica in the treatment of haemolytic anaemia.

Treatment of Hemolytic Anemia and Severe Thrombocytopenia with Highdose Methylprednisolone and Intravenous Immunoglobulins in SLE

(1994). Treatment of Hemolytic Anemia and Severe Thrombocytopenia with Highdose Methylprednisolone and Intravenous Immunoglobulins in SLE. Scandinavian Journal of Rheumatology: Vol. 23, No. 4, pp. 218-219.

Effects of recombinant human erythropoietin on haemolytic anaemia in mice

The effects of repeated administration of recombinant human erythropoietin (rHuEPO) were investigated in mice with haemolytic anaemia. Mice with haemolytic anaemia induced by phenylhydrazine (PHZ mice) were examined as an acute model and New Zealand black mice (NZB mice) at 13 months of age were examined as a chronic model. The plasma erythropoietin (EPO) level in PHZ mice was high and showed a strong inverse correlation with the Hb in the anaemia development period. However, it was relatively low in the recovery period from anaemia. On the other hand, the plasma EPO level in NZB mice showed a simple inverse correlation with the Hb. The rHuEPO was injected every day for a week into these mice. While a high plasma EPO level was maintained in PHZ mice, no significant effect was observed by injection with rHuEPO at dose of 600 IU/kg. However, in the recovery period from anaemia, RBC and haemoglobin in PHZ mice were increased by the rHuEPO treatment and recovered more quickly to their normal levels. In NZB mice, RBC and haemoglobin were also increased by treatment with rHuEPO at dose of 600 IU/kg. Anti-RBC autoantibodies and anti-EPO antibodies did not increase, while RBC and plasma EPO levels were increased by the rHuEPO treatment. These results suggest that some types of haemolytic anaemia are not always combined with high endogenous EPO levels and that exogenous rHuEPO may be effective for use in the treatment of haemolytic anaemia.

Splenectomy in the treatment of hemolytic anemia.

In 113 patients with hemolytic anemia splenectomy was performed, without mortality and with minimal morbidity. Fifty-three patients with congenital spherocytosis and two with congenital elliptocytosis had postoperative increases in hematocrit to normal or near-normal levels. Three patients with pyruvate kinase deficiency and three with thalassemia variants were improved. Splenectomy in 52 patients with autoimmune hemolytic anemia resulted in an excellent response in 64% (no further steroid therapy) and an improved status in another 21% (prednisone requirements, 15 mg/day or less). For conditions other than congenital spherocytosis, in which splenectomy is uniformly of value, a decision to remove the spleen should be based on severity of the hemolytic process, failure to respond to other therapies, and the potential for achieving significant improvement in anemia and other associated cytopenias.

Hemolytic anemia: a systematic approach to management.

The recognition, investigation, diagnosis, and treatment of hemolytic anemia are reviewed on the basis of a classification of the causes of hemolysis according to whether they are disorders of the membrane, hemoglobin, or metabolism of the erythrocyte; congenital or familial or acquired; and intrinsic or extrinsic.

Advances in Treatment of Some Common Neurologic Disorders. Diagnosis, Mechanisms, and Treatment of Hemolytic Anemias.

Advances in Treatment of Some Common Neurologic Disorders. Diagnosis, Mechanisms, and Treatment of Hemolytic Anemias.

Splenectomy in hemolytic anemia; results predicted by body scanning after injection of Cr51-tagged red cells.

SPLENECTOMY has been employed for many years in the treatment of hemolytic anemia. Although striking improvement can be expected in certain types of hemolytic anemia — particularly hereditary spherocytosis — results of splenectomy in other types have generally been unpredictable. The observations of Jandl et al.1 on body-surface scanning after the injection of red cells tagged with radioactive chromate (Cr51) suggested that this technic might be helpful in predicting the results of splenectomy. The present report is concerned with the evaluation of this procedure in 50 patients, including 10 in whom splenectomy was done. Material and Methods Patients were . . .