A moderate transfusion regimen may reduce iron loading in β-thalassemia major without producing excessive expansion of erythropoiesis

M. Cazzola, C. Borgna-Pignatti, F. Locatelli, L. Ponchio, Y. Beguin, P. De Stefano

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Hypertransfusion with a baseline hemoglobin of 10 to 12 g per dL is still considered by many to be the mainstay of conservative therapy for β-thalassemia major. However, this regimen is frequently associated with manifestations of transfusion iron overload, despite regular chelation therapy with subcutaneous desferoxamine. STUDY DESIGN AND METHODS: To verify whether a transfusion regimen with a target pretransfusion hemoglobin level between 9 and 10 g per dL can allow a significant reduction in blood consumption, while still effectively suppressing erythropoiesis, the records were reviewed of 32 β-thalassemia major patients, who were maintained at a pretransfusion hemoglobin of 11.3 ± 0.5 g per dL between 1981 and 1986. These patients were switched at the beginning of 1987 to a transfusion regimen with pretransfusion hemoglobin of 9.4 ± 0.4 g per dL. The degree of erythroid marrow activity was evaluated in these patients and in 32 subjects with β-thalassemia intermedia through the simple measurement of serum transferrin receptor. RESULTS: After the adoption of the moderate transfusion regimen, transfusion requirements decreased from 137 ± 26 to 104 ± 23 mL per kg per year of red cells (p

Original languageEnglish
Pages (from-to)135-140
Number of pages6
JournalTransfusion
Volume37
Issue number2
Publication statusPublished - Feb 1997

ASJC Scopus subject areas

  • Hematology
  • Immunology

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