Current and potential treatments of posttransfusion hyperhemolysis based on putative mechanisms
| Goals of treatments . | Treatments currently used . | Potentially useful drugs . |
|---|---|---|
| Supportive care | ||
| Hydratation, analgesic, oxygenation | ||
| Stimulation of erythropoiesis | ||
| Erythropoietin | ||
| Iron | ||
| Folates | ||
| Vitamin B12 | ||
| Inhibition of RBC destruction | ||
| Macrophages/antibody-mediated | ||
| Intravenous immunoglobulin | ||
| Complement cascade activation | ||
| Eculizumab | ||
| Other anti-C: C1 inhibitors39 | ||
| Elimination of toxic molecules from the plasma | ||
| Heme | Plasmapheresis | |
| Hemopexin40 | ||
| Hemoglobin | Plasmapheresis | |
| Haptoglobin40 | ||
| Antibodies | Plasmapheresis | |
| IgG endopeptidase41 | ||
| Activated fractions of complement, cytokines, other involved molecules | Plasmapheresis | |
| Anti-inflammatory action | ||
| Corticosteroids (balanced with vaso- occlusive risk) | ||
| Tocilizumab (case reports) | ||
| Safety of additional transfusion | ||
| Transfusion + rituximab | ||
| Transfusion + corticosteroids (balanced with vaso-occlusive risk) | ||
| Transfusion + Daratumumab (case report)42 | ||
| Transfusion + Bortezomib | ||
| Various goals | ||
| Bortezomib + Hemopure (case report)43 |
| Goals of treatments . | Treatments currently used . | Potentially useful drugs . |
|---|---|---|
| Supportive care | ||
| Hydratation, analgesic, oxygenation | ||
| Stimulation of erythropoiesis | ||
| Erythropoietin | ||
| Iron | ||
| Folates | ||
| Vitamin B12 | ||
| Inhibition of RBC destruction | ||
| Macrophages/antibody-mediated | ||
| Intravenous immunoglobulin | ||
| Complement cascade activation | ||
| Eculizumab | ||
| Other anti-C: C1 inhibitors39 | ||
| Elimination of toxic molecules from the plasma | ||
| Heme | Plasmapheresis | |
| Hemopexin40 | ||
| Hemoglobin | Plasmapheresis | |
| Haptoglobin40 | ||
| Antibodies | Plasmapheresis | |
| IgG endopeptidase41 | ||
| Activated fractions of complement, cytokines, other involved molecules | Plasmapheresis | |
| Anti-inflammatory action | ||
| Corticosteroids (balanced with vaso- occlusive risk) | ||
| Tocilizumab (case reports) | ||
| Safety of additional transfusion | ||
| Transfusion + rituximab | ||
| Transfusion + corticosteroids (balanced with vaso-occlusive risk) | ||
| Transfusion + Daratumumab (case report)42 | ||
| Transfusion + Bortezomib | ||
| Various goals | ||
| Bortezomib + Hemopure (case report)43 |