Survival of transfused red blood cells from a donor with alpha-thalassemia trait in a recipient with sickle cell disease.

Autor: Yee MEM; Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA., Covington ML; Joint Program in Transfusion Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Zerra PE; Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.; Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA., McCoy JW; Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA., Easley KA; Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Atlanta, Georgia, USA., Joiner CH; Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA., Bryksin J; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA., Francis RO; Department of Pathology and Cell Biology, Columbia University Medical Center, New York Presbyterian Hospital, New York, New York, USA., Lough CM; LifeSouth Community Blood Centers, Gainesville, Florida, USA., Patel N; Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA., Kutlar A; Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA., Josephson CD; Cancer and Blood Disorders Institute, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA.; Departments of Oncology and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Roback JD; Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA., Stowell SR; Joint Program in Transfusion Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Fasano RM; Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.; Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Jazyk: angličtina
Zdroj: Transfusion [Transfusion] 2024 Jun; Vol. 64 (6), pp. 1109-1115. Date of Electronic Publication: 2024 May 01.
DOI: 10.1111/trf.17857
Abstrakt: Background: Post-transfusion survival of donor red blood cells (RBCs) is important for effective chronic transfusion therapy in conditions including sickle cell disease (SCD). Biotin labeling RBCs allows direct in vivo measurement of multiple donor RBC units simultaneously post-transfusion.
Study Design and Methods: In an observational trial of patients with SCD receiving monthly chronic transfusion therapy, aliquots of RBCs from one transfusion episode were biotin-labeled and infused along with the unlabeled RBC units. Serial blood samples were obtained to measure RBC survival. Donor units were tested for RBC indices, hemoglobin fractionation, and glucose-6-phosphate dehydrogenase (G6PD) enzyme activity. For microcytic donor RBCs (MCV < 70 fL), HBA1 and HBA2 genetic testing was performed on whole blood.
Results: We present one recipient, a pediatric patient with SCD and splenectomy who received two RBC units with aliquots from each unit labeled at distinct biotin densities (2 and 18 μg/mL biotin). One donor unit was identified to have microcytosis (MCV 68.5 fL after biotinylation); whole blood sample obtained at a subsequent donation showed 2-gene deletion alpha-thalassemia trait (ɑ- 3.7kb /ɑ- 3.7kb ) and normal serum ferritin. G6PD activity was >60% of normal mean for both. The RBCs with alpha-thalassemia RBC had accelerated clearance and increased surface phosphatidylserine post-transfusion, as compared with the normocytic RBC (half life 65 vs. 86 days, respectively).
Discussion: Post-transfusion RBC survival may be lower for units from donors with alpha-thalassemia trait, although the impact of thalassemia trait donors on transfusion efficacy requires further study.
(© 2024 AABB.)
Databáze: MEDLINE
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