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Comparative Study
. 2022 Feb;37(1):100-105.
doi: 10.1002/jca.21956. Epub 2021 Dec 13.

Patients with hereditary hemochromatosis reach safe range of transferrin saturation sooner with erythrocytaphereses than with phlebotomies

Eva Rombout-Sestrienkova  1   2 , Lloyd Brandts  3 , Ger H Koek  1   4 , Cees Th B M van Deursen  1   5
Affiliations
Comparative Study

Patients with hereditary hemochromatosis reach safe range of transferrin saturation sooner with erythrocytaphereses than with phlebotomies

Eva Rombout-Sestrienkova et al. J Clin Apher. 2022 Feb.

Abstract

Introduction: For the maintenance treatment of patients with hereditary hemochromatosis (HH), it is advised to keep the transferrin saturation (TSAT) <70% to prevent formation of non-transferrin-bound iron and labile plasma iron. The period of the initial iron depletion may last up to 1 year or longer and during this period, the patient is exposed to elevated TSAT levels. Therapeutic erythrocytapheresis (TE) is a modality which has proven to reduce treatment duration of patients with iron overload from HH. In this study, we investigated the time to reach TSAT <70% for both treatment modalities.

Methods: From a previous randomized controlled trial comparing erythrocytaphereses with phlebotomies (PBMs), we performed an analysis in a subgroup of patients who presented with TSAT >70%. Mann-Whitney U tests were performed to compare the number of treatments and the number of weeks to reach the interim goal of a persistent level of <70% for TSAT between TE and PBM.

Results: The period to reach TSAT levels of <70% was statistically significant shorter for the TE group compared to the PBM treatment group (median treatment procedures [IQR] 2.0 (5) vs 16.0 (23), P-value: <.001, and median treatment duration [IQR]: 5.5 (11) vs 19.0 (29) weeks, P-value: .007).

Conclusion: Patients with HH reach a safe TSAT <70% significantly sooner and with less treatment procedures with TE compared to PBM.

Keywords: hereditary hemochromatosis; phlebotomy; therapeutic erythrocytapheresis; transferrin saturation.

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Conflict of interest statement

The authors declare no potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow diagram showing the breakdown of the patient numbers from the initial study to the present study
See this image and copyright information in PMC

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