Department of Clinical Immunology and Blood Centre, Rigshospitalet/Hvidovre Hospital, University Hospital of Copenhagen, Copenhagen, Denmark.
Vox Sang. 2013 Feb;104(2):110-4. doi: 10.1111/j.1423-0410.2012.01644.x. Epub 2012 Aug 15.
The literature contains little on the prevalence and causes of high predonation haemoglobin levels among blood donors. This study aimed to characterize and develop an algorithm to manage would-be donors with polycythaemia.
Between November 2009 and November 2011, we offered haematology consultations to blood donors with repeated haemoglobin concentration (Hb) above the WHO limit for polycythaemia vera (PV) (10·2 and 11·5 mm/16·5 and 18·5 g/dl for women and men, respectively). Investigation of such donors included Hb, haematocrit, mean cell volume, erythropoietin, ferritin, platelet count and leucocyte count, JAK2 V617 and JAK2 exon12 analysis, as well as other routine measurements.
Among 46 such donors, 39 had a history of smoking, which contributes to erythrocytosis. Two had PV, five had severe hypertension, one of them because of renal artery stenosis, and two had diabetes mellitus. Thus, we found a high morbidity among such donors. Of the 36 others, 30 donated again before May 2012, at which time the Hb was significantly lower.
We recommend JAK2 V617 and JAK2 exon12 screening and clinical investigation for donors with concurrently high Hb, high haematocrit and iron deficiency. We also recommend that they stop or cut down on smoking to reduce the risk of thrombosis in general. We disqualified 10 of the donors.
文献中关于献血者中血红蛋白水平偏高的流行情况和原因的报道较少。本研究旨在对可能患有红细胞增多症的献血者进行特征分析并开发一种管理算法。
在 2009 年 11 月至 2011 年 11 月期间，我们为血红蛋白浓度（Hb）多次高于真性红细胞增多症（PV）的世界卫生组织（WHO）限值（女性和男性分别为 10.2 和 11.5mm/16.5 和 18.5g/dl）的献血者提供血液学咨询。对这些献血者进行的检查包括 Hb、血细胞比容、平均红细胞体积、促红细胞生成素、铁蛋白、血小板计数和白细胞计数、JAK2 V617 和 JAK2 外显子 12 分析以及其他常规测量。
在 46 名此类献血者中，有 39 名有吸烟史，这会导致红细胞增多。其中 2 名患有 PV，5 名患有严重高血压，其中 1 名是由于肾动脉狭窄，2 名患有糖尿病。因此，我们发现此类献血者的发病率较高。其余 36 人中，有 30 人在 2012 年 5 月前再次献血，此时 Hb 明显降低。
我们建议对 Hb、血细胞比容和铁蛋白同时升高且伴有缺铁的献血者进行 JAK2 V617 和 JAK2 外显子 12 筛查和临床检查。我们还建议他们停止或减少吸烟，以降低总体血栓形成的风险。我们淘汰了 10 名献血者。
