Comparison between phlebotomy and erythrocytapheresis of iron overload in patients with HFE gene mutations

BACKGROUND AND OBJECTIVE: Large-volume erythrocytapheresis (EA) is an useful and speedy method to treat iron overload (10). We assesed the efficacy of EA in patients with HFE gene mutations and 10 compared to the classical phlebotomies. PATIENTS AND METHOD: Data from 9 patients with 10 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/1 for haemoglobin and 55 mu g/l for serum ferritin levels (vs. 17 mu g/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.