Burnać Iva Lucija, Bojanić Ines, Mazić Sanja, Lukić Marija, Ćepulić Branka Golubić
Department of Transfusion Medicine, University Hospital Sveti Duh, Zagreb, Croatia.
Clinical Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia; University of Applied Health Sciences, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
Hematol Transfus Cell Ther. 2024 Nov;46 Suppl 5(Suppl 5):S103-S108. doi: 10.1016/j.htct.2024.05.011. Epub 2024 Sep 7.
Therapeutic erythrocytapheresis has some advantages over therapeutic phlebotomy, the standard treatment for cytoreduction in polycythemia and hemochromatosis. Erythrocytapheresis can be performed on different cell separators, each with its own characteristics. We present our experience of therapeutic erythrocytapheresis in the treatment of polycythemia and hemochromatosis with an analysis of the performance of cytoreduction, and a comparison between the characteristics of intermittent- and continuous-flow cell separators.
During a 20-year period, 1731 procedures were performed in 125 patients, 1634 (94.4%) with a Haemonetics MCS+ separator and 97 (5.6%) with a Spectra Optia system device. The performance of cytoreduction using the Haemonetics MCS+ separator was analysed in 442 procedures performed in 56 patients and the performance of the two apheresis devices was compared.
Haemoglobin (Hb) and haematocrit (Hct) values were significantly reduced after erythrocytapheresis with the Haemonetics MCS+ device (Hb: 18.69%; Hct: 18.73%; p-values both <0.001). The reductions of Hb and Hct were significantly higher in the Haemonetics MCS+ procedure (p-value <0.001), but the Spectra Optia procedure depleted a significantly higher RBC volume (495 mL versus 442 mL) in a shorter time (18 min versus 36 min).
Both the Haemonetics MCS+ and Spectra Optia systems proved to be highly efficient and safe in RBC cytoreduction with short procedure times. Erythrocytapheresis reduces the frequency of necessary procedures thereby justifying its therapeutic use especially in eligible patients of working age.
治疗性红细胞单采术相较于治疗性放血术具有一些优势，治疗性放血术是真性红细胞增多症和血色素沉着症细胞数量减少的标准治疗方法。红细胞单采术可在不同的细胞分离机上进行，每种分离机都有其自身特点。我们介绍了治疗性红细胞单采术在真性红细胞增多症和血色素沉着症治疗中的经验，分析了细胞数量减少的效果，并比较了间歇流和连续流细胞分离机的特点。
在20年期间，对125例患者进行了1731次操作，其中1634次（94.4%）使用Haemonetics MCS+分离机，97次（5.6%）使用Spectra Optia系统设备。对56例患者进行的442次使用Haemonetics MCS+分离机的细胞数量减少操作的效果进行了分析，并比较了两种单采设备的效果。
使用Haemonetics MCS+设备进行红细胞单采术后，血红蛋白（Hb）和血细胞比容（Hct）值显著降低（Hb：18.69%；Hct：18.73%；p值均<0.001）。Haemonetics MCS+操作中Hb和Hct的降低幅度显著更高（p值<0.001），但Spectra Optia操作在更短时间内（18分钟对36分钟）消耗的红细胞体积显著更高（495毫升对442毫升）。
Haemonetics MCS+和Spectra Optia系统在红细胞细胞数量减少方面均被证明高效且安全，操作时间短。红细胞单采术减少了必要操作的频率，因此证明了其治疗用途，特别是对于符合条件的工作年龄患者。
