[Comparison between phlebotomy and erythrocytapheresis of iron overload in patients with HFE gene mutations].
OBJECTIVE
Large-volume erythrocytapheresis (EA) is an useful and speedy method to treat iron overload (IO). We assesed the efficacy of EA in patients with HFE gene mutations and IO compared to the classical phlebotomies.


METHODS
Data from 9 patients with IO treated with EA, using a discontinuous flow cell separator as a single needle procedure, for a period of 2 years, were compared to 9 matched patients who underwent conventional phlebotomies.


RESULTS
The mean volume of red blood cells removed in each EA was 275 ml, with a median reduction of 23 g/l for haemoglobin and 55 microg/l for serum ferritin levels (vs. 17 microg/l between phlebotomies). The liver function test returned to normal values in 4 out of 5 patients undergoing EA, but none of the phlebotomies. The time required to achieve iron depletion was 3 times shorter in EA group.


CONCLUSIONS
EA is an effective and safe procedure that achieves iron depletion more quickly than manual phlebotomies. Nevertheless, to determine its cost-effectiveness, economical, prospective, randomized studies are warranted.
Fernández-Mosteirín
Nuria
N
Servicio de Hematología y Hemoterapia, Hospital Miguel Servet, Zaragoza, España.
Salvador-Osuna
Carlos
C
García-Erce
José Antonio
JA
Orna
Elisa
E
Pérez-Lungmus
Gonzalo
G
Giralt
Manuel
M
D000328:Adult; D000368:Aged; D001781:Blood Component Removal / Q000379:methods; D004906:Erythrocyte Count; D017707:Erythrocyte Transfusion / Q000379:methods; D005260:Female; D005293:Ferritins / Q000097:blood; D006432:Hemochromatosis / Q000150:complications / Q000235:genetics / Q000628:therapy*; D000071020:Hemochromatosis Protein; D015395:Histocompatibility Antigens Class I / Q000032:analysis / Q000235:genetics; D006801:Humans; D019190:Iron Overload / Q000097:blood / Q000235:genetics / Q000628:therapy*; D008297:Male; D008565:Membrane Proteins / Q000032:analysis / Q000235:genetics; D008875:Middle Aged; D009154:Mutation; D018962:Phlebotomy; D016896:Treatment Outcome
C103673:HFE protein, human; D000071020:Hemochromatosis Protein; D015395:Histocompatibility Antigens Class I; D008565:Membrane Proteins; D005293:Ferritins