Journal of Hematology, ISSN 1927-1212 print, 1927-1220 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Hematol and Elmer Press Inc
Journal website https://jh.elmerpub.com

Original Article

Volume 14, Number 4, August 2025, pages 210-213

Novel Red Blood Cell Exchange Parameters for Treatment of Transfusion-Dependent Thalassemia Based on Experience of Five Patients

Figure

↓  Figure 1. Serum ferritin level trends pre- and post-transition to RBCX. Serum ferritin levels were trended for patients at 3-month intervals which showed ferritin stability or improvement as patients continued RBCX. RBCX: red blood cell exchange.
Figure 1.

Tables

↓  Table 1. RBCX Parameters Utilized for the Described TDT Patients Versus Previously Described Exchange Parameters Utilized for Patients With SCD
 
Parameter TDT RBCX SCD RBCX
Pre- and post-transfusion hematocrit targets were higher for TDT patients when compared to SCD parameters while the FCR goal was the same for both groups. FCR: fraction of cells remaining; RBCX: red blood cell exchange; SCD: sickle cell disease; TDT: transfusion-dependent thalassemia.
Transfusion interval (weeks) 4 - 6 4 - 7
Pre-transfusion hematocrit 29 (Hb 9.5 g/dL or higher) 25 - 27
Post-transfusion hematocrit target 37 - 38 30 in acute states; 32 - 34 in chronic exchanges
Isovolemic hemodilution Omitted Performed, if pre-transfusion hematocrit allows
FCR 30 30

 

↓  Table 2. Mean Ferritin Levels, Blood Utilization, and Transfusion Intervals for Each Patient
 
Patient Mean ferritin pre-RBCX (1 year prior) Mean ferritin post-RBCX (1 year post) Difference in ferritin Blood utilization pre-RBCX (mL) Blood utilization post-RBCX (mL) Simple transfusion interval (weeks) RBCX transfusion interval (weeks)
Mean serum ferritin decreased for the five patients once transitioned to chronic RBCX. Blood utilization (mL) increased on chronic RBCX while transfusion intervals (described in weeks) increased. RBCX: red blood cell exchange.
A 6,530 1,382 5,148 4,200 5,625 2 4
B 1,220 880 340 2,400 8,100 4 5
C 1,076 633 443 1,200 5,200 3 5
D 2,503 2,118 385 1,800 7,700 4 6
E 2,718 1,282 1,436 1,500 4,900 3 5