A prospective trial of young red cells in 48 patients with transfusion‐dependent thalassaemia

Marcus, Robert; Wonke, B; Bantock, H. M.; Thomas, Michael John Glyn; Parry, Ernest S.; Taite, H.; Huehns, E. R.

doi:10.1111/j.1365-2141.1985.tb07396.x

Cited by 28 publications

(11 citation statements)

References 15 publications

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“…The second [2], concerned six patients transfused with units of young red cells prepared from whole blood using the IBM 2991 Cell Processor; in this study the blood requirements were reduced over 1year by 8% to 24% (mean 15.8%) compared to the blood requirement of the same patients with standard units. Finally, Marcus et al [5] reported no differences between the blood requirements of 17 patients transfused with young red cells collected with the IBM 2991 Cell Processor compared to 20 patients transfused with normal blood.…”

Section: Discussionmentioning

confidence: 96%

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

et al. 1986

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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.

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Section: Discussionmentioning

confidence: 96%

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

et al. 1986

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“…The reduced iron load [5][6][7] should improve the iron balance, making the iron chelating agents, such as desferrioxamine (DFO), clinically more efficient [8]. Initial clinical studies of neocyte transfusions demon strated some benefits but were not as good as expected [5,9,10]. It was proposed that the benefits noted did not justify the marked increase in time and expense required to prepare neocytes by machine methods then available [11].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Neocyte Transfusion in the Management of Thalassaemia

Spanos¹,

Ladis²,

Palamidou³

et al. 1996

Vox Sanguinis

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Transfusional iron overload leading to cardiopathy and other severe complications continues to be a major problem in chronically transfused homozygous β-thalassaemia patients. It is well known that young red cells (neocytes) survive longer after transfusion and therefore may contribute to the extension of the intervals between transfusions. We evaluated the impact of neocytes in the total annual blood requirements and consequently the transfusional iron load in 18 thalassaemia patients. A two-period study comparing transfusions of standard red cells versus neocytes in the same group of patients was performed. Neocytes were harvested by density separation using the Neocel® System. The method of preparation was simple with relatively low costs and required no special equipment. There was a significant difference (p < 0.005) in PK and MCV values of the neocyte and older red cell (gerocyte) fractions indicating that a good separation of the two populations was achieved. All patients had a reduction in blood requirements during the neocyte period. The total annually transfused red blood cells and concomitant iron blood load were significantly reduced (pCO.OOl) by 20.2±9.1%. However, the response was variable. Seven of the 18 patients had a large reduction in blood consumption (24.8-34.8%), 9 others ranged between 10.7 and 21.6%, and in 2 the reduction was less than 10%. This reduction in blood requirements and in the transfused iron may change the chelation index resulting in more efficient iron chelation therapy and perhaps reduce the cost of the hae- mochromatosis therapy on a long-term basis. We conclude that the use of neocyte therapy using this system can benefit the majority of chronically transfused patients by reducing transfusional iron overload and related complications and may lead to a much better quality of life.

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“…Despite achieving similar results there were contrasting conclusions. Marcus et al concluded that the reduction in blood consumption was clinically insignificant because transfusion interval, mean Hb and rate of Hb fall were the same in both groups and, therefore, they did not advocate the use of young red cells (Marcus et al , 1985). Collins et al were guarded in their conclusion that despite benefits, processing costs and donor exposure would have to be considered before recommending this (Collins et al , 1994).…”

Section: Discussionmentioning

confidence: 99%