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European Journal of Pediatrics

, Volume 145, Issue 1–2, pp 10–13 | Cite as

Neocytopheresis: a new approach for the transfusion of patients with thalassaemia major

  • P. Triadou
  • R. Girot
  • D. Rebibo
  • D. Lemau
  • B. Mattlinger
  • P. Bolo
  • M. Maier-Redelsperger
  • L. Barritault
Original Investigations

Abstract

At present the treatment of thalassaemia major consists of regular blood transfusions coupled with chelation therapy using deferoxamine. A complementary approach to the problem is the use of blood units enriched with young red cells (neocytes), which reduce the transfusional frequency and thereby diminish the risk of iron overload. Young red cell units were collected from blood from 60 volunteer donors using a cell separator (IBM 2997). Donors' blood was anticoagulated and the young red cell harvesting carried out over 4 h at a constant rotor speed of 500 rpm. Three biological criteria were used to evaluate young red cell quality: the number of reticulocytes, the pyruvate kinase activity and the mean corpuscular volume, all of which show an enrichment of young red cells as compared to standard donor units. The 51Cr young red cell survival in four normal donors and in two splenectomized patients showed an increased red cell half-life compared to the same study performed with standard blood units. Blood consumption was diminished significantly when the two patients were transfused with young red cell units. It must be emphasized that, despite the high cost of this blood product, the efficiency of this transfusion technique, by reducing blood consumption, represents important progress and a hopeful treatment for chronic anaemia.

Key words

Neocytopheresis Thalassaemia Transfusion Anaemia 

Abbreviations

Hb

haemoglobin

MCV

mean corpuscular volume

PK

pyruvate kinase

TQ

transfusion quotient

R

reticulocytes

\({{\overline R } \mathord{\left/ {\vphantom {{\overline R } {\overline {Hb} }}} \right. \kern-\nulldelimiterspace} {\overline {Hb} }}\)

ratio reticulocytes/haemoglobin

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References

  1. 1.
    Boiteux F, Vilmer E, Girot R, Muller JY, Rouzioux C, Chamaret S, Montagnier L (1985) Lymphadenopathy syndrome in two thalassemic patients after LAV contamination by blood transfusion. New Engl J Med 312: 648–649Google Scholar
  2. 2.
    Cohen AR, Schmidt JM, Martin MB, Barnsley W, Schwartz E (1984) Clinical trial of young red cell transfusions. J Pediatr 104: 865–868Google Scholar
  3. 3.
    Corash L, Klein H, Deisseroth A, Shafer B, Rosen S, Beman JA, Griffith P, Nienhuis A (1981) Selective isolation of young erythrocytes for transfusion support of thalassemia major patient. Blood 57: 599–606Google Scholar
  4. 4.
    Graziano JH, Piomelli S, Seaman C, Wang T, Cohen AR, Kelleker JF, Schwartz E (1982) A simple technique for preparation of young red cells for transfusion from ordinary blood units. Blood 59: 865–868Google Scholar
  5. 5.
    Marcus RE, Bantock HM, Wonke B, Tate H, Thomas MJG, Parry ES, Huehns ER (1984) A trial of young red cells in 48 patients with transfusion dependent thalassaemia. Br J Haematol 56: 669–670Google Scholar
  6. 6.
    Modell B (1977) Total management of thalassaemia major. Arch Dis Child 52: 489–500Google Scholar
  7. 7.
    Piomelli S, Seaman C, Reibman J, Tytun A, Graziano J, Tabachnik N, Corash L (1978) Separation of younger red cells with improved survival in vivo: An approach to chronic transfusion therapy. Proc Natl Acad Sci USA 75: 3474–3478Google Scholar
  8. 8.
    Piomelli S, Danoff SJ, Becker MH, Lipera MJ, Travis SF (1969) Prevention of bone malformation and cardiomegaly in Cooley's anemia by early hypertransfusion regimen. Ann NY Acad Sci 165: 427–436Google Scholar
  9. 9.
    Pisciotto P, Kiraly T, Rosen D, Paradis L, Kakaiya RM, Morse EE (1984) Preparation of young red cells for transfusion using the Fenwal CS 3000 cell separator. Am J Hematol 17: 185–191Google Scholar
  10. 10.
    Propper RD, Button LN, Nathan DG (1980) New approaches to the transfusion management of thalassemia. Blood 55: 55–60Google Scholar
  11. 11.
    Propper RD, Cooper B, Ruffo RR, Nienhuis AW, Anderson WF, Bunn HF, Rosenthal A, Nathan DG (1977) Continuous subcutaneous administration of deferoxamine in patients with iron overload. New Engl J Med 297: 418–423Google Scholar
  12. 12.
    Wolman IJ (1964) Transfusion therapy in Cooley's anemia: Growth and health as related to long-range hemoglobin levels: A progress report. Ann NY Acad Sci 199: 736–747Google Scholar

Copyright information

© Springer-Verlag 1986

Authors and Affiliations

  • P. Triadou
    • 1
  • R. Girot
    • 1
  • D. Rebibo
    • 2
  • D. Lemau
    • 2
  • B. Mattlinger
    • 2
  • P. Bolo
    • 2
  • M. Maier-Redelsperger
    • 1
  • L. Barritault
    • 3
  1. 1.Laboratoire d'HématologieHôpital des Enfants MaladesParis Cedex 15France
  2. 2.Centre de Transfusion sanguineHôpital des Enfants MaladesParis Cedex 15France
  3. 3.Service de Médecine NucléaireHôpital LaennecParis Cedex 15France

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