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Tytuł:
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Manual erythroexchange in sickle cell disease: multicenter validation of a protocol predictive of volume to exchange and hemoglobin values.
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Autorzy:
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Gianesin B; Hemoglobinopathies and Congenital Anemia Center, Ospedale Galliera, Genoa, Italy.
Pinto VM; Hemoglobinopathies and Congenital Anemia Center, Ospedale Galliera, Genoa, Italy.
Casale M; Department of Woman Child and General Surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy.
Corti P; Pediatrics Unit, Monza e Brianza per il Bambino e la sua Mamma Foundation (FMBBM), Monza, Italy.
Fidone C; Thalassemia Center, SIMI Ragusa, Ragusa, Italy.
Quintino S; Hemoglobinopathies and Congenital Anemia Center, Ospedale Galliera, Genoa, Italy.
Voi V; Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.
Forni GL; Hemoglobinopathies and Congenital Anemia Center, Ospedale Galliera, Genoa, Italy. .
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Źródło:
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Annals of hematology [Ann Hematol] 2020 Sep; Vol. 99 (9), pp. 2047-2055. Date of Electronic Publication: 2020 Jul 21.
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Typ publikacji:
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Journal Article; Multicenter Study
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Język:
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English
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Imprint Name(s):
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Publication: Berlin : Springer Verlag
Original Publication: Berlin ; New York : Springer International, c1991-
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MeSH Terms:
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Anemia, Sickle Cell/*blood
Anemia, Sickle Cell/*therapy
Blood Volume/*physiology
Blood Volume Determination/*standards
Erythrocyte Transfusion/*standards
Hemoglobin, Sickle/*metabolism
Adult ; Anemia, Sickle Cell/epidemiology ; Blood Volume Determination/methods ; Erythrocyte Transfusion/methods ; Female ; Humans ; Italy/epidemiology ; Male ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Reproducibility of Results ; Young Adult
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Contributed Indexing:
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Keywords: Hb; HbS%; MEEX; Sickle cell disease; Volumes exchanged
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Substance Nomenclature:
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0 (Hemoglobin, Sickle)
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Entry Date(s):
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Date Created: 20200722 Date Completed: 20200824 Latest Revision: 20200824
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Update Code:
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20240104
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DOI:
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10.1007/s00277-020-04188-y
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PMID:
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32691114
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Manual erythroexchange (MEEX) was proven to be effective and safe in the management of sickle cell disease (SCD). The goal is to quickly reduce the percentage of hemoglobin S (HbS%). A national survey of the Italian Society for Thalassemia and Hemoglobinopathies (SITE) observed a great variability among MEEX protocols none of which were found to be predictive of the values of HbS% and hemoglobin (Hb) after the exchange. Two equations to estimate the HbS% and Hb values to be obtained after MEEX were developed based on the results of the MEEX procedures in place in the centers participating in the present study. A standard protocol was subsequently defined to evaluate the volumes to exchange to obtain the target values of HbS% and Hb. The protocol was tested in 261 MEEX performed in SCD patients followed in the 5 participating centers that belong to the Italian Hemoglobinopathy Comprehensive Care Network, with the support of the SITE. The results showed a correlation between the estimated and measured values of HbS% and Hb (R p 0.95 and 0.65 respectively, p < 0.001). A negligible bias was found for the prediction of HbS% and a bias of 1 g/dl for Hb. From consecutive MEEX, a rate of increase of HbS% between two exchanges of around 0.4% per day (p < 0.001) was measured. This protocol was shown to be effective and safe, as all patients reached the target value of HbS%. All the MEEX procedures were carried out with single venous access. No adverse events or reactions such as hypotension or electrolyte imbalance were reported nor were any complaints concerning the procedures received from patients.
