Naeem Usman, Baseer Najma, Khan Muhammad Tariq Masood, Hassan Muhammad, Haris Muhammad, Yousafzai Yasar Mehmood
Institute of Pathology and Diagnostic Medicine, Khyber Medical University Phase-5, Hayatabad, Peshawar, Khyber Pakhtunkhwa, Pakistan.
Institute of Basic Medical Sciences, Khyber Medical University Phase-5, Hayatabad, Peshawar, Khyber Pakhtunkhwa, Pakistan.
Am J Blood Res. 2021 Dec 15;11(6):592-599. eCollection 2021.
The aim of this study was to investigate the hematological and biochemical effects of stored blood transfusion on patients with transfusion-dependent thalassemia (TDT).
In this quasi-experimental study, 20-patients with TDT were enrolled. Each participant received on first visit, freshly collected red cell concentrate (RCC) (<2-days storage) and 15-days later on second visit, 7-days stored blood. Blood samples were obtained immediately before and 24-hours after each transfusion. Differences in the Complete blood counts, bilirubin, LDH, C-Reactive protein, ferritin, and iron levels in the pre- and post-transfusion samples were compared between the first and second transfusion.
Fresh blood transfusion resulted in a higher (but non-significant) increase in hemoglobin and other red cell parameters. Notably, a significant increase in white cell counts (WCC) was seen in 7-days stored blood vs fresh blood (1.82×10/l vs 1.01×10/l, P=0.002). No statistically significant difference was found in LDH, direct and indirect bilirubin, creatinine, blood glucose, serum uric acid, serum ferritin, and serum Iron levels. There was a statistically significant rise in C-reactive protein levels in stored (6.43±7.46 mg/dl) versus fresh RCC (1.89±2.38 mg/dl), -value =0.012.
We show that in patients with chronic TDT, an increase in inflammation-associated markers (WCC and CRP) is observed. Further studies to assess the extent and duration of this increase are needed.
本研究旨在调查储存血液输注对依赖输血的地中海贫血（TDT）患者的血液学和生化影响。
在这项准实验研究中，招募了20例TDT患者。每位参与者在首次就诊时接受新鲜采集的红细胞浓缩液（RCC）（储存时间<2天），15天后的第二次就诊时接受储存7天的血液。在每次输血前和输血后24小时立即采集血样。比较第一次和第二次输血前后输血样本中全血细胞计数、胆红素、乳酸脱氢酶（LDH）、C反应蛋白、铁蛋白和铁水平的差异。
新鲜血液输注导致血红蛋白和其他红细胞参数有更高（但无统计学意义）的升高。值得注意的是，与新鲜血液相比，储存7天的血液中白细胞计数（WCC）显著增加（1.82×10⁹/l对1.01×10⁹/l，P = 0.002）。在LDH、直接和间接胆红素、肌酐、血糖、血清尿酸、血清铁蛋白和血清铁水平方面未发现统计学显著差异。储存血液（6.43±7.46mg/dl）与新鲜RCC（1.89±2.38mg/dl）相比，C反应蛋白水平有统计学显著升高，P值 = 0.012。
我们表明，在慢性TDT患者中，观察到炎症相关标志物（WCC和CRP）增加。需要进一步研究以评估这种增加的程度和持续时间。
