[fancypants27]

This is off topic - but hoping someone here

My mom goes for bi-weekly blood transfusions. (for the last 3 months or so). She has developped antibodies which I hear is common. She started with 4 antibodies. Her last transfusion on Friday did not help at all, and she has to go back for another one today. They also found out yesterday that she now has over 20 antibodies. So cross matching is becoming a bit of a pain.
What would be the next step for her if blood transfusions don't work?

They have lowered her medication which is causing the low blood cel counts from 6 pills to 2 and it hasn't helped.......

[Katie81]

What cell counts are low? Platelets, hemoglobin, or is her INR high? What is the underlying issue?

[LindsayGriff]

Hard to say what the next step is if we don't know the diagnosis. Does she have aplastic anemia, myelodysplastic syndrome, autoimmune hemolytic anemia?

[.h00dihoo.this.]

ugh, to many big words here!

[fancypants27]

Hemolytic anemia from being on ribavirin combo therapy for liver disease. Blood cell count has gone under 70. Have tried bone marrow injection with no success, and has been on the bi-weekly transfusions for about 3 months now.

She keeps saying that there is nothing else they can do if transfusions don't work and her blood levels will just keep getting lower and she will just die. ???!!!

I havent been able to find anything on dr google in regards to developing that many antibodies...

[LindsayGriff]

In a quick search about ribivirin induced hemolytic anemia, this is what I got

In general, ribavirin dose reduction or the use of
red blood cell growth factors (erythropoietin) are recommended
when the hemoglobin level goes below 10 g/dL
or if there is a significant drop in hemoglobin
levels over a short period of time. People with
cardiac disease should be monitored very
carefully when the hemoglobin level starts
to drop. Ribavirin treatment may have to be
discontinued if the drop in hemoglobin level is
substantial. The general recommendation is to
stop taking ribavirin or combo therapy altogether if
the hemoglobin level drops below 8.5 g/dL.

So based on this and you telling me that her hemoglobin is less than probably 7 according to these unit factors, I would talk to her liver doctor about stopping the medication all together and then I would also make sure she has a hematologist (blood doctor) working with her to give her the best treatments to bring her levels back up. With all those antibodies in her blood it will make it hard for her to receive transfusions, especially if she needs them quickly and those with liver disease are at an increased risk of having bleeding problems and could need transfusions sometime on an emergent basis.

[fancypants27]

She had another transfusion today - and goes back on Monday to check her bloods. She was worried because she had 2 bags with different antibodies.... hospital said for the next transfusion they will have to call people from the database that are a match and hope they will donate.

Thanks for the info - she is on a trial for this combo therapy so the dr is looking into alternatives rather than taking her off the meds. Treatment is costing close to 100k for the 12 months and she is 6-7 months in, so everyone is hoping that there is something that can be done besides taking her off the ribavirin. Not to mention, the treatment seems to be working and although blood counts are low, liver enzymes are now normal. She has stage 3-4 cirrhosis....so kind of a last hope before transplant.