Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis · 2025
Clinical application of erythrocytapheresis in the treatment of erythrocytosis.
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Yi Zhongmei, Zhou Fang, Zhou Yumeng, Wu Chunxi, Zhang Bin
Аннотация
BACKGROUND: This study aimed to clarify the clinical utility of erythrocytapheresis as a treatment for erythrocytosis, including polycythemia vera and secondary erythrocytosis.
MATERIAL AND METHODS: A retrospective analysis was conducted on 83 patients (84.34 % male, mean age 49.66 years (16.23 years)) who underwent a total of 104 erythrocytapheresis sessions between September 2021 and April 2025. The key parameters measured included the depleted red blood cell (RBC) volume, the hemoglobin (HB) and hematocrit (Hct) reductions, and adverse reactions.
RESULTS: Erythrocytapheresis significantly reduced the post-treatment RBC counts (25.22 %), the HB (25.19 %) level and the Hct (23.62 %), the white blood cell counts, (23.37 %) and the platelet counts (8.38 %) (all p < 0.05). The median depleted RBC volume was 1405.5 mL (range 1011.75-1677.5 mL). The median post-treatment target Hct was 40 % (range 40-45 %). The mean post-treatment Hct was in fact 47.57 % (6.54 %), which was higher than the target, and the mean Hct error ratio was 14.23 % (12.95 %). When the replacement solution was physiological saline, an adverse reaction (hypotension) occurred during 4.81 % of the 104 erythrocytapheresis sessions, but only in patients with a depleted RBC volume/weight (D/W) ≥ 25 mL/kg. No significant differences were observed between the Spectra Optia and COM.TEC blood cell separators.
DISCUSSION: Erythrocytapheresis effectively reduces the RBC mass in patients with erythrocytosis.In rough terms, the post-treatment target Hct = the post-treatment Hct × 0.88, our research team has officially designated this formula as the 'Southwest Formula'. In the future, we will continue to expand the sample size to enhance the precision of this formula and better guide the clinical application of erythrocytapheresis.
MATERIAL AND METHODS: A retrospective analysis was conducted on 83 patients (84.34 % male, mean age 49.66 years (16.23 years)) who underwent a total of 104 erythrocytapheresis sessions between September 2021 and April 2025. The key parameters measured included the depleted red blood cell (RBC) volume, the hemoglobin (HB) and hematocrit (Hct) reductions, and adverse reactions.
RESULTS: Erythrocytapheresis significantly reduced the post-treatment RBC counts (25.22 %), the HB (25.19 %) level and the Hct (23.62 %), the white blood cell counts, (23.37 %) and the platelet counts (8.38 %) (all p < 0.05). The median depleted RBC volume was 1405.5 mL (range 1011.75-1677.5 mL). The median post-treatment target Hct was 40 % (range 40-45 %). The mean post-treatment Hct was in fact 47.57 % (6.54 %), which was higher than the target, and the mean Hct error ratio was 14.23 % (12.95 %). When the replacement solution was physiological saline, an adverse reaction (hypotension) occurred during 4.81 % of the 104 erythrocytapheresis sessions, but only in patients with a depleted RBC volume/weight (D/W) ≥ 25 mL/kg. No significant differences were observed between the Spectra Optia and COM.TEC blood cell separators.
DISCUSSION: Erythrocytapheresis effectively reduces the RBC mass in patients with erythrocytosis.In rough terms, the post-treatment target Hct = the post-treatment Hct × 0.88, our research team has officially designated this formula as the 'Southwest Formula'. In the future, we will continue to expand the sample size to enhance the precision of this formula and better guide the clinical application of erythrocytapheresis.