THE IMPACT OF NEOCYTE TRANSFUSION IN THE MANAGEMENT OF THALASSEMIA

Transfusional iron overload leading to cardiopathy and other severe co mplications continues to be a major problem in chronically transfused homozygous beta-thalassaemia patients. It is well known that young red cells (neocytes) survive longer after transfusion and therefore may c ontribute to the extension of the intervals between transfusions. We e valuated the impact of neocytes in the total annual blood requirements and consequently the transfusional iron load in 18 thalassaemia patie nts. A two-period study comparing transfusions of standard red cells v ersus neocytes in the same group of patients was performed. Neocytes w ere harvested by density separation using the Neocel(R) System. The me thod of preparation was simple with relatively low costs and required no special equipment. There was a significant difference (p < 0.005) i n PK and MCV values of the neocyte and older red cell (gerocyte) fract ions indicating that a good separation of the two populations was achi eved. All patients had a reduction in blood requirements during the ne ocyte period. The total annually transfused red blood cells and concom itant iron blood load were significantly reduced (p < 0.001) by 20.2+/ -9.1%. However, the response was variable. Seven of the 18 patients ha d a large reduction in blood consumption (24.8-34.8%), 9 others ranged between 10.7 and 21.6%, and in 2 the reduction was less than 10%. Thi s reduction in blood requirements and in the transfused iron may chang e the chelation index resulting in more efficient iron chelation thera py and perhaps reduce the cost of the haemochromatosis therapy on a lo ng-term basis. We conclude that the use of neocyte therapy using this system can benefit the majority of chronically transfused patients by reducing transfusional iron overload and related complications and may lead to a much better quality of life.