IŞIK KAYGUSUZ, MERAL SÖNMEZOĞLU, TUNÇ ÖNEŞ, FUAT DEDE, MUSTAFA ÇETINER, SEMA AKTAŞ, MAHMUT BAYIK
Journal of Blood Banking and Transfusion Medicine of Turkey - 2003;1(1):24-30
Although blood transfusion is an important part of the medical treatment, it is associated with a number of complications. Several disorders such as hemoglobinopathy, myelodysplasia, bone marrow aplasia, some haematological malignancies, and infiltration of bone marrow require blood transfusions at regular intervals. The patients receiving blood transfusions may be at risk in terms of alloimmunization. Allosensitization may cause difficulty in finding the appropriate blood product. Moreover, the interaction between the alloantibodies in serum and the antigens on the transfused erythrocytes may shorten the life span of erythrocytes. In addition to the development of antibodies, splenomegaly, microangiopathic hemolysis, bleeding, the age of the transfused erythrocytes, and gender may have effects on the life span of erthrocytes. The present study aimed to assess the frequency of the alloantibody development in terms of its effects on the life span of erythrocytes together with the effects of other parameters such as splenomegaly and iron overload. The present study included the patients who need blood transfusion on a regular basis due to myelodysplastic syndrome, aplastic anemia, chronic lymphocytic leukemia, and chronic myelocytic leukemia or those who had developed aplasia in their bone marrow following chemotherapy performed for acute leukemia, and those who had received 5 or more blood transfusions within the last 6 months. For each patient, we measured the serum level of ferritin, and determined the size of spleen using ultrasonography. Following the tests for screening and identifying alloantibodies, the donor erythrocytes labeled with Cr51 were transfused to the patients. In the blood samples taken at certain time points, the concentration of radioactive Cr was measured, and the T50 time (time during which the concentration of circulating Cr decreases to the half of the baseline value) was determined during a follow-up period of 21 days. The rate of the alloantibody development was found 10,71 % for overall patients. We observed that the T50 time was shortened in 8 patients, including one patient who developed alloantibodies. There was no statistically significant association between the alloantibody development and the T50 time. We could not show a substantial effect of age, gender, the size of spleen, and the serum level of ferritin on the T50 time. There was an inverse correlation between the age of the banked blood and the T50 time. As shown in our study, the banked blood which was stored for a long time was cleared from the circulation more rapidly, and required the blood transfusions more frequently and at higher amounts compared with the fresh blood. This is particularly important for the patients who were dependent on the blood transfusions.
