Anemia-induced bleeding in thrombocytopenic patients with blood cancer

Patients with blood cancers (e.g. leukemia) commonly develop anemia (low hemoglobin levels) and thrombocytopenia (low platelet levels) in their blood at the same time, putting them at an especially high risk of bleeding. The effect of concurrent anemia and thrombocytopenia has been described in animal models, but not in humans. Studies suggest that increasing the hemoglobin to near normal levels with red blood cell (RBC) transfusions might significantly reduce the risk of bleeding in these patients. We have designed a pilot trial to test the impact of a high hemoglobin level (110 g/L) or a standard hemoglobin level (70 g/L) on blood biomakers. The biomarkers will give an indication of 1) the amount of inflammation (the body’s response to injury), 2) coagulation (the body’s attempt at blood clotting), and 3) endothelial damage (the health of the blood vessels). The results of this study will help us design a large clinical trial to see if a high hemoglobin level can reduce the risk of bleeding in this patient population. Ultimately, this research will lead to a better understanding of how RBCs and platelets interact with each other and will allow us to make better decisions about the use of RBC transfusions.

ARNOLD, Donald

McMaster University

Graduate Fellowship Program

Ontario

$70,000