title: Erythrocytapheresis compared with whole blood phlebotomy for the treatment of hereditary haemochromatosis.
abstract: BACKGROUND
  Hereditary haemochromatosis may result in severe organ damage which can be prevented by therapy. We studied the possible advantages and disadvantages of erythrocytapheresis as compared with phlebotomy in patients with hereditary haemochromatosis.
  
  
  METHODS
  In a prospective, randomised, open-label study, patients with hereditary haemochromatosis were randomised to bi-weekly apheresis or weekly whole blood phlebotomy. Primary end-points were decrease in ferritin levels and transferrin saturation. Secondary endpoints were decrease in haemoglobin levels, discomfort during the therapeutic procedure, costs and technicians' working time.
  
  
  RESULTS
  Sixty-two patients were included. Thirty patients were randomised to apheresis and 32 to whole blood phlebotomy. Initially, ferritin levels declined more rapidly in the apheresis group, and the difference became statistically highly significant at 11 weeks; however, time to normalisation of ferritin level was equal in the two groups. We observed no significant differences in decline of transferrin saturation, haemoglobin levels or discomfort. The mean cumulative technician time consumption until the ferritin level reached 50 μg/L was longer in the apheresis group, but the difference was not statistically significant. The cumulative costs for materials until achievement of the desired ferritin levels were three-fold higher in the apheresis group.
  
  
  CONCLUSIONS
  Treatment of hereditary haemochromatosis with erythrocytapheresis instead of whole blood phlebotomy results in a more rapid initial decline in ferritin levels and a reduced number of procedures per patient, but not in earlier achievement of target ferritin level. The frequency of discomfort was equally low with the two methods. The costs and, probably, technician time consumption were higher in the apheresis group.
authors: Department of Immunology and Transfusion Medicine, Haugesund Hospital, Helse Fonna, Haugesund, Norway.
authors: Tatjana
authors: T
authors: Sundic
authors: Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway Department of Clinical Science, University of Bergen, Bergen, Norway.
authors: Tor
authors: T
authors: Hervig
authors: Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.
authors: Signe
authors: S
authors: Hannisdal
authors: Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.
authors: Jörg
authors: J
authors: Assmus
authors: Department of Clinical Science, University of Bergen, Bergen, Norway Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway.
authors: Rune J
authors: RJ
authors: Ulvik
authors: Department of Transfusion Medicine, Akershus University Hospital, Nordbyhagen, Norway.
authors: Richard W
authors: RW
authors: Olaussen
authors: Department of Medicine, Haugesund Hospital, Helse Fonna, Haugesund, Norway.
authors: Sigbjørn
authors: S
authors: Berentsen
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D016238:Cytapheresis / Q000191:economics; D005260:Female; D005293:Ferritins / Q000097:blood; D005838:Genotype; D006432:Hemochromatosis / Q000097:blood / Q000191:economics / Q000235:genetics / Q000628:therapy*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007501:Iron / Q000097:blood; D008297:Male; D017056:Medical Laboratory Personnel / Q000191:economics; D008875:Middle Aged; D009664:Norway; D018962:Phlebotomy / Q000191:economics; D011446:Prospective Studies; D013997:Time Factors; D014168:Transferrin / Q000032:analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D014168:Transferrin; D005293:Ferritins; D007501:Iron