Choe Won Ho, Park Borae G, Lee Kyoo-Hyung, Lee Je-Hwan, Lee Jung-Hee, Kwon Seog-Woon
Department of Laboratory Medicine, Eulji Medical Center, Eulji University School of Medicine, Seoul, South Korea.
J Clin Apher. 2012 Nov;27(5):255-9. doi: 10.1002/jca.21241. Epub 2012 Jul 11.
Phlebotomy has been used as a primary method for the treatment of erythrocytosis. As a new phlebotomy method, we used an automated component collection system (Alyx, Fenwal), which has been used to obtain two units of leukoreduced red blood cells (RBCs) from donors. We evaluated the effectiveness of "double red-cell" phlebotomy (DRP) and compared it with conventional "whole-blood" phlebotomy (WBP).
We have performed a total of 596 phlebotomies in 158 patients with erythrocytosis between June 2008 and November 2011. Forty patients underwent 84 DRPs and 118 patients underwent 512 WBPs. We removed 360-420 mL of RBCs in DRP and 360-600 mL of whole blood in WBP according to patient's total blood volume (TBV). Changes in hematologic parameters after phlebotomy were compared.
DRP removed more RBC volume (399.4 ± 20.2 mL vs. 235.9 ± 29.8 mL, P < 0.05) and lowered more hematocrit than WBP (6.9% ± 2.3% vs. 3.0% ± 1.7%, P < 0.05). Hematocrit reduction per kilogram of body weight was higher by DRP than WBP (0.106% ± 0.043% vs. 0.039% ± 0.025%, P < 0.05). Mild adverse events occurred in 32.5% (13/40) during DRP and 4.2% (5/118) during WBP.
DRP lowered more RBC mass than WBP by selectively removing more RBC volume with less TBV. DRP can be an effective and safe technique for the treatment of erythrocytosis.
放血疗法一直是治疗红细胞增多症的主要方法。作为一种新的放血方法，我们使用了自动成分采集系统（Alyx，芬瓦公司），该系统已用于从献血者中获取两单位白细胞滤除红细胞（RBC）。我们评估了“双红细胞”放血疗法（DRP）的有效性，并将其与传统的“全血”放血疗法（WBP）进行比较。
2008年6月至2011年11月期间，我们对158例红细胞增多症患者共进行了596次放血治疗。40例患者接受了84次DRP，118例患者接受了512次WBP。根据患者的总血容量（TBV），我们在DRP中去除360 - 420 mL的RBC，在WBP中去除360 - 600 mL的全血。比较放血后血液学参数的变化。
DRP比WBP去除更多的RBC体积（399.4 ± 20.2 mL对235.9 ± 29.8 mL，P < 0.05），且降低的血细胞比容更多（6.9% ± 2.3%对3.0% ± 1.7%，P < 0.05）。DRP每千克体重降低的血细胞比容高于WBP（0.106% ± 0.043%对0.039% ± 0.025%，P < 0.05）。DRP期间32.5%（13/40）发生轻度不良事件，WBP期间4.2%（5/118）发生轻度不良事件。
DRP通过以较少的TBV选择性地去除更多的RBC体积，比WBP降低更多的RBC量。DRP可能是一种治疗红细胞增多症的有效且安全的技术。
