Decreased levels of ferritin, mild thrombocytosis, and increased erythropoietin are sequential events among frequent plateletpheresis donors: Implication for a ferritin screen.

BACKGROUND

It is generally recognized that repeat apheresis increases the risk for iron deficiency, thus may impact on the blood homeostasis. With regard to donor vigilance, we clarified the mid- to long-term effects of plateletapheresis by comparing the most frequent donors with the first-time ones in hematological and biochemical tests.

METHODS

Levels of erythropoietin (EPO), hemoglobin (Hb) and ferritin were analyzed in double-unit (500 mL whole blood or 6 × 10 apheresis platelets) donations in three male cohorts, with identifiers of first-time whole-blood donors (n = 30), first-time platelet donors transited from maximal whole blood to apheresis (n = 30) and frequent donors subjected to extreme plateletpheresis (n = 90), respectively. According to the number of donations, the last earnest cohort, who donate almost 24 times a year, was further subdivided into three groups- casual (76-120 life-time donations in 5 years), mediocre (121-168 within 7 years) and enthusiastic (≥169 within 7 years and a month).

RESULTS

Regardless of the donation experience in whole blood or plateletpheresis, iron deficiency (serum ferritin concentrations <15 μg/L) was identified in all earnest cohorts. The ferritin means were significantly lower in plateletpheresis groups, with the lowest values in the enthusiastic group. EPO levels showed a significant inverse correlation with ferritin (p = 0.015, r = -0.224). Long-term earnest donors had the lowest iron stores accompanied by a later thrombocytosis and a final increase in EPO was revealed.

CONCLUSION

Regular ferritin screens are crucial to ensure a high level of donor health protection.