The relationship between the number of units of blood transfused and indicators of
iron status in 37 patients with sickle cell anaemia (Hb SS),
SC disease (Hb SC) or S beta-thalassaemia has been studied. The correlation coefficient between serum
ferritin and the number of units transfused was good (r = 0.86), provided that
ferritin samples taken within one week following a crisis were excluded. The relationship of transfusion history to serum
ferritin in the steady state showed a similar relationship to that previously observed for other multiply transfused patients. The serum
ferritin taken within 7 days of a painful crisis was significantly greater than the serum
ferritin from the same patients in the steady state (p less than 0.025). The serum
alanine transaminase did not rise as consistently as the serum
ferritin during crises; it correlated with the serum
ferritin but not the transfusion burden in the steady state.
Transferrin iron saturation correlated less clearly with transfusion history than serum
ferritin (r = 0.62). Patients who had received exchange transfusions were less likely to be
iron-overloaded (
ferritin increment per unit of blood = 9.9 +/- 3.8 micrograms/l) than patients who had received an equivalent number of units by conventional transfusion (
ferritin increment per unit of blood transfused = 25.1 +/- 2.42 micrograms/l).