Relationship between red blood cell transfusion volume and posttransfusional iron overload in hematological diseases

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  • ASHIDA Takashi
    Division of Hematology and Rheumatology, Department of Internal Medicine, Kinki University, Faculty of Medicine Center for Transfusion and Cell Therapy, Kinki University Hospital
  • KAWANO Ami
    Center for Transfusion and Cell Therapy, Kinki University Hospital
  • YAMADA Erika
    Center for Transfusion and Cell Therapy, Kinki University Hospital
  • IDE Daisuke
    Center for Transfusion and Cell Therapy, Kinki University Hospital
  • SUGANO Chiemi
    Center for Transfusion and Cell Therapy, Kinki University Hospital
  • KATO Yuko
    Center for Transfusion and Cell Therapy, Kinki University Hospital
  • TSUBAKIMOTO Yuko
    Center for Transfusion and Cell Therapy, Kinki University Hospital
  • ITO Shiho
    Center for Transfusion and Cell Therapy, Kinki University Hospital
  • MINE Yoshiko
    Center for Transfusion and Cell Therapy, Kinki University Hospital
  • FUJITA Michiko
    Center for Transfusion and Cell Therapy, Kinki University Hospital
  • KANEMITSU Yasushi
    Center for Transfusion and Cell Therapy, Kinki University Hospital
  • MORISHIMA Yoshiyuki
    Center for Transfusion and Cell Therapy, Kinki University Hospital
  • MORITA Yasuyoshi
    Division of Hematology and Rheumatology, Department of Internal Medicine, Kinki University, Faculty of Medicine
  • TANAKA Hirokazu
    Division of Hematology and Rheumatology, Department of Internal Medicine, Kinki University, Faculty of Medicine
  • SHIMADA Takahiro
    Division of Hematology and Rheumatology, Department of Internal Medicine, Kinki University, Faculty of Medicine
  • KAWANISHI Kazunobu
    Division of Hematology and Rheumatology, Department of Internal Medicine, Kinki University, Faculty of Medicine
  • MIYATAKE Junichi
    Division of Hematology and Rheumatology, Department of Internal Medicine, Kinki University, Faculty of Medicine
  • TATSUMI Yoichi
    Division of Hematology and Rheumatology, Department of Internal Medicine, Kinki University, Faculty of Medicine
  • MATSUMURA Itaru
    Division of Hematology and Rheumatology, Department of Internal Medicine, Kinki University, Faculty of Medicine Center for Transfusion and Cell Therapy, Kinki University Hospital

Bibliographic Information

Other Title
  • 血液疾患における赤血球輸血量と輸血後鉄過剰症の現状
  • 臨床研究 血液疾患における赤血球輸血量と輸血後鉄過剰症の現状
  • リンショウ ケンキュウ ケツエキ シッカン ニ オケル セッケッキュウ ユケツリョウ ト ユケツ ゴテツ カジョウショウ ノ ゲンジョウ
  • 4. Expectation for Clinical Pharmacology from Bed Side

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Abstract

We retrospectively investigated the status of transfusional iron overload at Kinki University Hospital. One hundred and sixty three patients received more than 10 red blood cell (RBC) units per year in 2009 and 2010. Myelodysplastic syndrome (37.4%) and aplastic anemia (11.0%) accounted for about 50% of the underlying diseases. At the time of receiving a total of 20 RBC units, 90.8% and 66.2% of the 65 patients evaluated had more than 500 and 1,000 ng/ml of serum ferritin, respectively. The frequency of organ dysfunction associated with iron overload was 56.9% of all the patients assessed, 37.8% of patients with serum ferritin levels of 500∼999 ng/ml, and 67.4% of patients with serum ferritin levels >1,000 ng/ml. Although the Japanese guidelines propose 40 units of RBC transfusion and/or a serum ferritin level of 1,000 ng/ml as a good point to start iron chelation therapy, our results suggest that iron overload and consequent organ dysfunction may occur earlier than this. Therefore, it may be necessary to start iron chelation therapy earlier than that suggested by the Japanese guidelines.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 54 (4), 365-369, 2013

    The Japanese Society of Hematology

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