Skip Navigation LinksHome > August 2013 - Volume 35 - Issue 6 > Partial Manual Exchange Reduces Iron Accumulation During Chr...
Journal of Pediatric Hematology/Oncology:
doi: 10.1097/MPH.0b013e31829d470d
Original Articles

Partial Manual Exchange Reduces Iron Accumulation During Chronic Red Cell Transfusions for Sickle Cell Disease

Savage, William J. MD, PhD*; Reddoch, Shirley MD; Wolfe, Jaime MD; Casella, James F. MD

Collapse Box


Iron overload is an inevitable consequence of chronic red cell transfusions without erythrocytapheresis or chelation therapy. The effectiveness of partial manual exchange, a technique used to slow iron loading, has not been evaluated. We evaluated all children with sickle cell disease (SCD) receiving chronic transfusion to identify chelation-naive subjects who had quantitative liver iron concentration (LIC) studies. Seventeen chelation-naive children with SCD received a median of 29 transfusions before first LIC determination. Serum ferritin concentrations were assessed before each transfusion. The mean volume of blood phlebotomized before each transfusion was 5.1±1.8 mL/kg, which cumulatively resulted in a calculated median of 35.0 mg/kg iron removal. Using linear regression, pretransfusion phlebotomy resulted in a statistically significant reduction in ferritin (−8.8 ng/mL of ferritin for each mg/kg of iron phlebotomized, P=0.02). A reduction in LIC from pretransfusion phlebotomy could not be established (P=0.4). Partial manual exchanges appear to be an effective strategy for slowing the pace of iron loading in the setting of chronic transfusion for SCD.

© 2013 by Lippincott Williams & Wilkins.


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.

Connect With Us


For additional oncology content, visit LWW Oncology Journals on Facebook.