Adams D M, Schultz W H, Ware R E, Kinney T R
Duke-UNC Comprehensive Sickle Cell Center, Duke University Medical Center, Durham, NC 27710, USA.
J Pediatr Hematol Oncol. 1996 Feb;18(1):46-50. doi: 10.1097/00043426-199602000-00009.
This research was undertaken to determine the advantages, complications, costs, and efficacy of erythrocytapheresis in young pediatric patients who receive chronic erythrocyte transfusion therapy.
We retrospectively analyzed data for 10 children who received erythrocytapheresis for an average of 16 months. Erythrocytapheresis was compared to simple transfusion therapy with respect to annual blood unit exposure, occurrence of alloimmunization, and costs. Serum ferritin levels were compared before and after the period of erythrocytapheresis.
Erythrocytapheresis was well tolerated, even in children as young as 5 years or as small as 20 kg. It required a greater annual unit exposure than simple transfusions, but did not increase alloimmunization. Ferritin levels decreased significantly in children receiving concurrent deferoxamine, and decreased or stabilized in those not on chelation therapy. Children started on erythrocytapheresis soon after stroke have not developed iron overload. Although the costs of erythrocytapheresis exceed that of simple transfusion, the substantial costs of deferoxamine therapy should be considered; one child on erythrocytapheresis has been able to discontinue chelation therapy following normalization of his ferritin level.
Erythrocytapheresis is a safe and effective method for young patients receiving chronic erythrocyte transfusions. Erythrocytapheresis can reduce total iron burden and may obviate the need for expensive chelation therapy.
本研究旨在确定红细胞单采术在接受慢性红细胞输血治疗的小儿患者中的优势、并发症、成本和疗效。
我们回顾性分析了10例平均接受红细胞单采术16个月的儿童的数据。将红细胞单采术与单纯输血治疗在年度血单位暴露、同种免疫的发生情况和成本方面进行了比较。比较了红细胞单采术前后的血清铁蛋白水平。
红细胞单采术耐受性良好，即使是5岁或体重低至20 kg的儿童。与单纯输血相比，它需要更高的年度血单位暴露，但不会增加同种免疫。接受去铁胺治疗的儿童铁蛋白水平显著下降，未接受螯合治疗的儿童铁蛋白水平下降或稳定。中风后不久开始接受红细胞单采术的儿童未出现铁过载。虽然红细胞单采术的成本超过单纯输血，但应考虑去铁胺治疗的高昂成本；一名接受红细胞单采术的儿童在铁蛋白水平恢复正常后已能够停止螯合治疗。
红细胞单采术对于接受慢性红细胞输血的年轻患者是一种安全有效的方法。红细胞单采术可以减轻总铁负荷，并可能无需进行昂贵的螯合治疗。
