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Erythrocytapheresis can reduce iron overload and prevent the need for chelation therapy in chronically transfused pediatric patients.
Adams, D M; Schultz, W H; Ware, R E; Kinney, T R.
Afiliación
  • Adams DM; Duke-UNC Comprehensive Sickle Cell Center, Duke University Medical Center, Durham, NC 27710, USA.
J Pediatr Hematol Oncol ; 18(1): 46-50, 1996 Feb.
Article en En | MEDLINE | ID: mdl-8556370
ABSTRACT

PURPOSE:

This research was undertaken to determine the advantages, complications, costs, and efficacy of erythrocytapheresis in young pediatric patients who receive chronic erythrocyte transfusion therapy. PATIENTS AND

METHODS:

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.

RESULTS:

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.

CONCLUSION:

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.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Terapia por Quelación / Citaféresis / Transfusión de Eritrocitos / Anemia de Células Falciformes Tipo de estudio: Health_economic_evaluation / Observational_studies Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: J Pediatr Hematol Oncol Asunto de la revista: HEMATOLOGIA / NEOPLASIAS / PEDIATRIA Año: 1996 Tipo del documento: Article País de afiliación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Terapia por Quelación / Citaféresis / Transfusión de Eritrocitos / Anemia de Células Falciformes Tipo de estudio: Health_economic_evaluation / Observational_studies Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: J Pediatr Hematol Oncol Asunto de la revista: HEMATOLOGIA / NEOPLASIAS / PEDIATRIA Año: 1996 Tipo del documento: Article País de afiliación: Estados Unidos