You Made the Call
We asked, and you answered! Here are a few responses
from this month’s “You Make the Call.”
For the full description of the clinical dilemma, and to
see how the expert responded, turn to page 53.
Clinical Dilemma:
A 33-year-old woman with sickle cell disease is planning
to undergo bariatric surgery with a Roux-en-Y procedure.
How should transfusion be managed through this surgery?
Should she have exchange transfusion prior to surgery?
I would propose to transfuse the patient with two to three
units of RBC concentrates at about weekly intervals, starting 4 weeks before the planned surgical intervention. This
will suppress her own production of erythrocytes, and she
will have enough HbA before surgery.
Bernhard Lämmle, MD
Center for Thrombosis and Hemostasis, University Medical Center Mainz
Mainz, Germany
Common molecular genetic mutations in AML
FLT3
(ITD, TKD)
37%
53
TP
P
KR TEN
A
PH S 2%
F6 2%
AS
X