Nifong T P, Bongiovanni M B, Gerhard G S
Department of Pathology, Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA.
Transfusion. 2001 Feb;41(2):256-63. doi: 10.1046/j.1537-2995.2001.41020256.x.
Erythrocytapheresis is used to prevent acute chest syndrome and stroke in patients with sickle cell disease (SCD). However, such regimens are associated with significant risks, such as iron overload and potential exposure to transfusion-transmitted infectious diseases. Computer modeling of erythrocytapheresis procedures may help optimize treatments and minimize risks.
Mathematical models based upon material balance equations and patient-specific statistical analyses were developed to estimate HbS levels immediately after erythrocytapheresis and immediately before the next treatment. The equations were incorporated into a software application that was used to model the effects of various treatment values on four patients treated with 90 erythrocytapheresis procedures.
Immediate postprocedure HbS values were accurately estimated with correlations between measured and calculated values ranging from R(2) = 0.83 to 0.96. Estimates of HbS just before the next treatment correlated well in three patients (R(2) = 0.71 to 0.83) but poorly in one (R(2) = 0.28 to 0.46). Varying the treatment values by computer simulation led to a wide variation in the number of RBC units and the net RBC volume transfused.
Computer modeling of erythrocytapheresis can be used to optimize chronic treatment regimens for SCD patients and potentially to minimize the risks of overtransfusion.
红细胞单采术用于预防镰状细胞病（SCD）患者的急性胸部综合征和中风。然而，此类治疗方案存在显著风险，如铁过载以及潜在的输血传播感染性疾病暴露风险。红细胞单采术程序的计算机建模可能有助于优化治疗并将风险降至最低。
基于物质平衡方程和患者特异性统计分析开发了数学模型，以估计红细胞单采术后即刻及下次治疗前即刻的血红蛋白S（HbS）水平。这些方程被纳入一个软件应用程序，该程序用于对接受90次红细胞单采术治疗的4例患者的各种治疗参数的效果进行建模。
术后即刻HbS值得到准确估计，测量值与计算值之间的相关性范围为R² = 0.83至0.96。在下一次治疗前对HbS的估计在3例患者中相关性良好（R² = 0.71至0.83），但在1例患者中相关性较差（R² = 0.28至0.46）。通过计算机模拟改变治疗参数导致输注的红细胞单位数量和净红细胞体积有很大差异。
红细胞单采术的计算机建模可用于优化SCD患者的长期治疗方案，并有可能将过度输血的风险降至最低。
