Effect of the Leukostop® filter on pulmonary function following blood transfusion in patients with thalassemia major

Abstract

Summary. This study evaluated the effect of the Leukostopா filter, a device which reduces the number of leukocytes in blood, on pulmonary function in 15 patients with thalassemia major. Spirometry and oxygen saturation were used to evaluate the influence of filtering the blood. The transfusions consisted of blood which had or had not passed through a Leukostopா filter.Blood transfusion induced a significant drop in FEV 1 /FVC ratio in 4 patients, an effect which disappeared following use of the Leukostopா filter. Oxygen saturation improved after 6 months of using the Leukostopா filter and improved acutely following blood transfusion (both with and without the filter).We conclude that removing most of the leukocytes from the blood during transfusions prevents bronchoconstriction and improves oxygen saturation. Pediatr Pulmonol. 1999; 28:277-281.

The hypercoagulable state in thalassemia

“…51 Removal of leukocytes from transfused blood with a Leukostop filter resulted in improved pulmonary function tests (forced expiratory volume in 1 second/forced vital capacity ratio) in 4 patients with ␤-TM, 6 months after the procedure. 52 This clinical observation illustrates the deleterious effect that activated granulocytes can induce in the lungs of patients with thalassemia.…”

Effect of Using Bedside Leukocyte Filter on Pulmonary Functions in Patients with Thalassemia Major

“…The fact that using the leukocyte filter prevented the drop in FEV1/FVC% indicated that leukocytes are most likely responsible for the physiological abnormalities noted when leukocytes are not removed. The leukocyte filter was discontinued for 3 months and a clear deterioration in baseline lung function was seen in their patients [9]. Furthermore, their study and ours showed a statistically significant improvement in the chest X-ray findings before and after using the leukocyte filter.…”

“…Similarly, Kivity et al [9] stated that patients with thalassemia, who had earlier exhibited an obstructive pattern with reduction in O2 saturation, showed an improvement of FEV1/FVC ratio after the use leukocyte filter, together with a significant increase in other spirometric values. The fact that using the leukocyte filter prevented the drop in FEV1/FVC% indicated that leukocytes are most likely responsible for the physiological abnormalities noted when leukocytes are not removed.…”

“…Azarkeivan et al [1], had 72.7% of their patients with restrictive pattern and 2.2% with combined pattern. Pulmonary hemosiderosis and interstitial fibrosis have been reported resulting in restrictive pattern; yet, an obstructive pattern has also been described, but the cause has not been explained [9]. Piatti et al [10] suggested that the reason for restrictive pattern of lung dysfunction in β-thalassemia may be deposition and tissue accumulation of iron.…”