Haemolysis in Patients with Chronic Lymphocytic Leukaemia during Extracorporeal Irradiation of the Blood

Abstract

Erythrocyte destruction was studied in six patients with chronic lymphocytic leukaemia treated with extracorporeal irradiation of the blood (ECI). Before treatment all patients were anaemic. 51Cr‐labelling showed an apparent half‐life of 14 to 19 days indicating a reduced erythrocyte life span. 59Fe‐data were suggestive of random destruction of erythrocytes in four of the six patients. During the later part of the ECI period considerable reticulocytosis developed, and increased disappearance rate of 51Cr‐label was evident after a mean cumulative erythrocyte dose between 18,500 and 34,000 rads had been reached. This indicates the occurrence of haemolysis which was most pronounced in the one patient with a slightly positive Coombs' test. The 59Fe‐curves were either unaffected by the irradiation or showed only minor effects; since labelling was performed immediately before treatment, this indicates that young erythrocytes are less radiosensitive.

Extracorporeal Irradiation of the Blood

“…The treatment is time-consuming, but if ECIB is given in connection with haemodialysis, half the time can be saved. The damage to the erythrocytes reported in in vitro studies and in leucaemia (1,17) could not be demonstrated in uraemic patients (21). In the present small material the infectious complications were not increased after ECIB.…”

SURVIVAL OF DF32P‐LABELLED ERYTHROCYTES IN URAEMIC PATIENTS DURING EXTRACORPOREAL IRRADIATION OF THE BLOOD

“…Studies with 51Cr labelling have shown a decreased survival in vivo of normal human erythrocytes after in vitro irradiation with 35000 rads (14). In patients with chronic lymphocytic leukaemia undergoing ECIB an increased loss of W.3 activity from the blood was observed when MCED reached 18 500-34 000 rads (1). A decreased H b concentration and reticulocytosis were observed in 4 of 5 uraemic patients during ECIB with MCED of 20 000-35 OOO rads (1 3).…”

Radiation Induced Changes in Red Cell Filterability

“…Recently, evidence for radiation induced haemolysis during E.C.I. has been presented (Storb et al 1969, Andersen et al 1970, and red blood cells show a reduced survival time in vivo after irradiation in vitro (Schiffer et al 1966).…”