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Normalized levels of red blood cells expressing phosphatidylserine, their microparticles, and activated platelets in young patients with β-thalassemia following bone marrow transplantation

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Abstract

Bone marrow transplantation (BMT) serves as the only curative treatment for patients with β-thalassemia major; however, hemostatic changes have been observed in these BMT patients. Aggregability of thalassemic red blood cells (RBCs) and increased red blood cell-derived microparticles (RMPs) expressing phosphatidylserine (PS) are thought to participate in thromboembolic events by initially triggering platelet activation. To our knowledge, there has been no report providing quantitation of these circulating PS-expressing RBCs and RMPs in young β-thalassemia patients after BMT. Whole blood from each subject was fluorescently labeled to detect RBC markers (CD235a) and annexin-V together with the known number TruCount™ beads. PS-expressing RBCs, RMPs, and activated platelets were identified by flow cytometry. In our randomized study, we found the decreased levels of three aforementioned factors compared to levels in patients receiving regular blood transfusion (RT). This study showed that BMT in β-thalassemia patients decreases the levels of circulating PS-expressing RBCs, their MPs, and procoagulant platelets when compared to patients who received RT. Normalized levels of these coagulation markers may provide the supportive evidence of the effectiveness of BMT for curing thalassemia.

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Acknowledgements

We thank the staff at the Hematology-Oncology Division, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, for recruiting subjects and helping in blood sample collection. Thanks also go to Dr. Arthur E. Brown for editing the manuscript. PK and SV were financially supported by the Thailand Research Fund (TRF) RGJ-PhD scholarship. EN thanks the Faculty of Medicine Siriraj Hospital, Mahidol University, for supporting the research project. KP was the recipient of the TRF-Distinguished Research Professor Award (grant contact number DPG5980001).

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Authors and Affiliations

  1. Graduate Program in Immunology, Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Phatchanat Klaihmon & Sinmanus Vimonpatranon

  2. Research Division, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand

    Egarit Noulsri

  3. Division of Hematology-Oncology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

    Surapong Lertthammakiat, Usanarat Anurathapan, Nongnuch Sirachainan & Suradej Hongeng

  4. Center of Excellence for Flow Cytometry, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand

    Kovit Pattanapanyasat

Authors
  1. Phatchanat Klaihmon
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  2. Sinmanus Vimonpatranon
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  3. Egarit Noulsri
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  4. Surapong Lertthammakiat
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  5. Usanarat Anurathapan
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  6. Nongnuch Sirachainan
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  7. Suradej Hongeng
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  8. Kovit Pattanapanyasat
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Contributions

PK, SV, EN performed the experiments, analyzed the data and wrote manuscript; SL, UA, NS supervised the project and analyzed the data; SH, KP designed the experiment, wrote, and edited the paper.

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Correspondence to Kovit Pattanapanyasat.

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Electronic supplementary material

Supplementary Table 1

Demographic data of two patient groups. (DOCX 17 kb)

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Klaihmon, P., Vimonpatranon, S., Noulsri, E. et al. Normalized levels of red blood cells expressing phosphatidylserine, their microparticles, and activated platelets in young patients with β-thalassemia following bone marrow transplantation. Ann Hematol 96, 1741–1747 (2017). https://doi.org/10.1007/s00277-017-3070-2

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  • DOI: https://doi.org/10.1007/s00277-017-3070-2

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