Clinical effects of different types of red cell concentrates in patients with thalassemia and sickle cell disease

S, Cabibbo; Fidone, Carmelo; Antolino, Agostino; Manenti, Oriella; Garozzo, Giovanni; Travali, S.; Bennardello, Francesco; Stefano, R. Di; Bonomo, Pietro

doi:10.1016/j.tracli.2008.03.006

Cited by 4 publications

(6 citation statements)

References 17 publications

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“…More commonly, units are stored with additive solutions which yield longer shelf life but have lower hematocrit of 55%–65% and higher volume of 300–350 ml 105,106 . Apheresis‐derived units are not recommended for transfusions in adults due to smaller hemoglobin increments 103,105 . Patients who demonstrate recurrent allergic reactions should be given washed units using a process that minimizes loss of blood 107 .…”

Section: Transfusion Recommendations For β Thalassemiamentioning

confidence: 99%

“…When citrate phosphate dextrose‐adenine is used as the anticoagulant‐preservative unit, the hematocrit of the final unit is 65%–80% and the volume 250–300 ml. More commonly, units are stored with additive solutions which yield longer shelf life but have lower hematocrit of 55%–65% and higher volume of 300–350 ml 105,106 . Apheresis‐derived units are not recommended for transfusions in adults due to smaller hemoglobin increments 103,105 .…”

Section: Transfusion Recommendations For β Thalassemiamentioning

confidence: 99%

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The transfusion management of beta thalassemia in the United States

et al. 2021

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The β thalassemia syndromes constitute the most frequent inherited anemia managed with chronic red cell transfusions around the world. 1,2 The prevalence of thalassemia in the United States was underestimated in past surveys that were limited only to the major specialty centers. 3 Recent data show that the aggregate number of patients followed at smaller centers and community practices surpasses those at the major centers. 4 A precise estimate of the total number of individuals with thalassemia in the U.S. is unavailable due to the lack of either a state or national database. Surveys have shown that 10 large thalassemia centers in the country collectively follow about 1100 patients, while additional 1500 patients are estimated to receive care at other hospitals. 4,5 The Thalassemia Western Consortium (TWC) study showed that of the 717 patients, 44% of patients had β thalassemia syndromes (including 15% with HbE β thalassemia) and 55% had various α thalassemia disorders. Transfusion-dependent patients comprised 35% of the population, 9% had received 1 or more life-time transfusions, and 56% had never been transfused. Thus,

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Section: Transfusion Recommendations For β Thalassemiamentioning

confidence: 99%

Section: Transfusion Recommendations For β Thalassemiamentioning

confidence: 99%

The transfusion management of beta thalassemia in the United States

et al. 2021

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“…Thalassemic patients represented an ideal setting to verify the usefulness of ABT leukodepletion. Although leukodepletion reduces non-hemolytic febrile reactions (NHFR)88–90 and anti-leukocyte antibodies and anti-platelet production91, 92 it does not modify substantially the immunologic alterations observed in thalassemic patients 92 Probably, their pathogenesis is very complex and TRIM represents only one of the numerous factors interfering with immunity.…”

Section: Etiology Of Risks Of Infections In Thalassemia and Hemoglobimentioning

confidence: 99%

Infections in Thalassemia and Hemoglobinopathies

Ricerca¹,

Girolamo²,

Rund³

2009

Medit J Hemat Infect Dis

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The clinical approach to thalassemia and hemoglobinopathies, specifically Sickle Cell Disease (SCD), based on transfusions, iron chelation and bone marrow transplantation has ameliorated their prognosis. Nevertheless, infections still may cause serious complications in these patients. The susceptibility to infections in thalassemia and SCD arises both from a large spectrum of immunological abnormalities and from exposure to specific infectious agents. Four fundamental issues will be focused upon as central causes of immune dysfunction: the diseases themselves; iron overload, transfusion therapy and the role of the spleen. Thalassemia and SCD differ in their pathogenesis and clinical course. It will be outlined how these differences affect immune dysfunction, the risk of infections and the types of most frequent infections in each disease. Moreover, since transfusions are a fundamental tool for treating these patients, their safety is paramount in reducing the risks of infections. In recent years, careful surveillance worldwide and improvements in laboratory tests reduced greatly transfusion transmitted infections, but the problem is not completely resolved. Finally, selected topics will be discussed regarding Parvovirus B19 and transfusion transmitted infections as well as the prevention of infectious risk postsplenectomy or in presence of functional asplenia.

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“…Among RCC obtained from whole blood donations, the Italian guidelines consider those prepared by pre‐storage filtration of whole blood, without removing the buffy coat, as preferable for this reason 3 . However, the only clinical support for this opinion comes from a retrospective observational study 4 …”

Section: Introductionmentioning

confidence: 99%

Impact of the preparation method of red cell concentrates on transfusion indices in thalassemia patients: A randomized crossover clinical trial

et al. 2021

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Background The average hemoglobin content of red cell concentrates (RCC) varies depending on the method of preparation. Surprisingly less data are available concerning the clinical impact of those differences. Study Design and Methods The effects of two types of RCC (RCC‐A, RCC‐B) on transfusion regime were compared in a non‐blinded, prospective, randomized, two‐period, and crossover clinical trial. RCC‐A was obtained by whole blood leukoreduction and subsequent plasma removal, RCC‐B removing plasma and buffy coat first, followed by leukoreduction. Eligible patients were adult, with transfusion‐dependent thalassemia (TDT). Results RCC‐A contained 63.9 (60.3–67.8) grams of hemoglobin per unit (median with 1st and 3rd quartile), RCC‐B 54.5 (51.0–58.2) g/unit. Fifty‐one patients completed the study. With RCC‐B, the average pre‐transfusion hemoglobin concentration was 9.3 ± 0.5 g/dl (mean ± SD), the average transfusion interval 14.2 (13.7–16.3) days, the number of RCC units transfused per year 39.3 (35.4–47.3), and the transfusion power index (a composite index) 258 ± 49. With RCC‐A, the average pre‐transfusion hemoglobin concentration was 9.6 ± 0.5 g/dl (+2.7%, effect size 0.792), the average transfusion interval 14.8 (14.0–18.5) days (+4.1%, effect size 0.800), the number of RCC units transfused per year 34.8 (32.1–42.5) (−11.4%, effect size −1.609), and the transfusion power index 272 ± 61 (+14.1%, effect size 0.997). All differences were statistically highly significant (p < .00001). The frequency of transfusion reactions was 0.59% with RCC‐A and 0.56% with RCC‐B (p = 1.000). Conclusion To reduce the number of RCC units consumed per year and the number of transfusion episodes, TDT patients should receive RCC with the highest average hemoglobin content.

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Clinical effects of different types of red cell concentrates in patients with thalassemia and sickle cell disease

Cited by 4 publications

References 17 publications

The transfusion management of beta thalassemia in the United States

The transfusion management of beta thalassemia in the United States

Infections in Thalassemia and Hemoglobinopathies

Impact of the preparation method of red cell concentrates on transfusion indices in thalassemia patients: A randomized crossover clinical trial

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