Comparison of Two Alternative Procedures to Obtain Packed Red Blood Cells for β-Thalassemia Major Transfusion Therapy

Abstract

β-thalassemia major (βTM) patients require frequent blood transfusions, with consequences that span from allogenic reactions to iron overload. To minimize these effects, βTM patients periodically receive leucodepleted packed red blood cells (P-RBCs) stored for maximum 14 days. The aim of this study was to compare two alternative routine procedures to prepare the optimal P-RBCs product, in order to identify differences in their content that may somehow affect patients’ health and quality of life (QoL). In method 1, blood was leucodepleted and then separated to obtain P-RBCs, while in method 2 blood was separated and leucodepleted after removal of plasma and buffycoat. Forty blood donors were enrolled in two independent centers; couples of phenotypically matched whole blood units were pooled, divided in two identical bags and processed in parallel following the two methods. Biochemical properties, electrolytes and metabolic composition were tested after 2, 7 and 14 days of storage. Units prepared with both methods were confirmed to have all the requirements necessary for βTM transfusion therapy. Nevertheless, RBCs count and Hb content were found to be higher in method-1, while P-RBCs obtained with method 2 contained less K+, iron and storage lesions markers. Based on these results, both methods should be tested in a clinical perspective study to determine a possible reduction of transfusion-related complications, improving the QoL of βTM patients, which often need transfusions for the entire lifespan.

Reduction of EpCAM-Positive Cells from a Cell Salvage Product Is Achieved by Leucocyte Depletion Filters Alone

“…Analyses were carried out using a CELL-DYN Ruby Hematology Analyzer (Abbott Laboratories). Haemolysis was estimated following the Harboe direct spectrophotometric method, as already published [ 22 ]. Briefly, free haemoglobin (HbO 2 ) absorbance was measured at 415 nm (ε = 512 mM −1 cm −1 ); the percentage of haemolysis was derived using the free Hb concentration in the supernatants, the total Hb and the HCT.…”

Transfusion management in thalassemia

“…RBC count and Hgb content were found to be higher in method one, while PRBCs obtained with method two contained less potassium, iron, and oxidative stress markers. The authors concluded that more clinical studies considering the possible long‐term consequences of these differing aspects should be done with thalassemia patients 19 …”

“…The authors concluded that more clinical studies considering the possible long-term consequences of these differing aspects should be done with thalassemia patients. 19…”

Non-Vitamin K Antagonist Oral Anticoagulants in Patients with β-Thalassemia

“…The disease is characterized by wide genotypic and phenotypic variability: the heterozygous state, which was previously considered a “minor” form of β-thalassemia, is usually asymptomatic and causes only mild anemia. On the other hand, homozygosis may result in β-thalassemia “intermedia”; which ranges in clinical severity from asymptomatic to transfusion-dependent forms, or in β-thalassemia “major”; which is the more severe disease, leading to a serious form of anemia in which survival is possible only with regular blood transfusions [ 3 , 4 ]. In the latter case, chelation therapy is required in order to reduce the adverse effects of iron overload due to red blood cell transfusions.…”