Related Experiment Video
Updated: Sep 9, 2025
Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
Novel Red Blood Cell Exchange Parameters for Treatment of Transfusion-Dependent Thalassemia Based on Experience of
Kristina Sevcik1,2, Claire Jackson3,2, Shelly M Williams1
1Department of Pathology, Microbiology and Immunology, University of Nebraska Medical Center, Omaha, NE, USA.
Background:
Thalassemias are inherited red blood cell disorders characterized by defective globin production, resulting in microcytic hypochromic anemia. Severe variants lead to transfusion dependence and consequent iron overload, often despite chelation therapy. The role of automated red blood cell exchange (RBCX) for transfusion-dependent thalassemia (TDT) is unclear and previously there was no specific apheresis parameters specific for thalassemia defined. We present our experience with patients with TDT treated with RBCX using higher hematocrit parameters specifically tailored for this condition.
Methods:
Five patients with TDT underwent chronic RBCX in place of simple transfusion with the primary goal of stabilizing iron overload. Novel parameters were established to satisfy the Thalassemia International Federation goal pre-transfusion hemoglobin of 9.5 g/dL, while targeting a post-transfusion hematocrit of 37-38%.
Results:
RBCX was well tolerated with infrequent occurrences of vasovagal reactions, asymptomatic hypotension, citrate side effects, and vascular access issues. The transfusion interval increased from an average of 3 weeks with simple transfusions to 5 weeks with RBCX. Despite an increase in average blood utilization, serum ferritin levels remained stable.
Conclusion:
RBCX with higher hematocrit parameters can be performed safely and efficiently in TDT patients. To our knowledge, this is the first report of TDT-specific RBCX parameters. Though blood utilization is higher with RBCX, it offers longer intervals between transfusions and has no increase in iron overload, improving quality of life for patients.
More Related Videos
07:24A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy
11:59Detection of Residual Donor Erythroid Progenitor Cells after Hematopoietic Stem Cell Transplantation for Patients with Hemoglobinopathies
Published on: September 6, 2017
Related Concept Videos
02:45Blood Transfusion and Agglutination
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
01:15Blood Transfusion
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
01:22Bone Marrow Sampling and Transplants
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
01:27Disorders of Erythrocytes
Erythrocyte disorders can be broadly categorized into two main types: anemic and polycythemic conditions.
A low oxygen-carrying capacity of the blood due to the loss, lower production, or destruction of erythrocytes is termed anemia. Hemorrhagic anemia, for example, occurs when bleeding from an external wound or internal ulcer reduces erythrocyte counts.
On the other...
01:14Erythropoiesis
01:24Factors Affecting Erythropoiesis
Several factors influence the erythrocyte production rate, with tissue oxygen level being among the most critical. Intense exercise or high altitudes can cause tissue hypoxia, which triggers the kidneys to release more erythropoietin (EPO) into the bloodstream.
EPO then...