{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T14:55:52Z","timestamp":1785250552278,"version":"3.55.0"},"reference-count":50,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,9,11]],"date-time":"2014-09-11T00:00:00Z","timestamp":1410393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Therapeutic phlebotomy is increasingly used in patients with transfusional siderosis to mitigate organ injury associated with iron overload (<jats:styled-content style=\"fixed-case\">IO<\/jats:styled-content>). Laboratory response variables and therapy duration are not well characterized in such patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Methods<\/jats:title><jats:p>We retrospectively evaluated 99 consecutive patients undergoing therapeutic phlebotomy for either transfusional <jats:styled-content style=\"fixed-case\">IO<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">TIO<\/jats:styled-content>, n\u2009=\u200988; 76% had undergone hematopoietic transplantation) or nontransfusional indications (hyperferritinemia or erythrocytosis; n\u2009=\u200911). Complete blood cell count, serum ferritin (<jats:styled-content style=\"fixed-case\">SF<\/jats:styled-content>), transferrin saturation, and transaminases were measured serially. Phlebotomy goal was an <jats:styled-content style=\"fixed-case\">SF<\/jats:styled-content> level of less than 300\u2009\u03bcg\/L.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean <jats:styled-content style=\"fixed-case\">SF<\/jats:styled-content> levels before phlebotomy among <jats:styled-content style=\"fixed-case\">TIO<\/jats:styled-content> and nontransfusional subjects were 3093 and 396\u2009\u03bcg\/L, respectively. Transfusion burden in the <jats:styled-content style=\"fixed-case\">TIO<\/jats:styled-content> group was 94\u2009\u00b1\u2009108 (mean\u2009\u00b1\u2009<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>) <jats:styled-content style=\"fixed-case\">RBC<\/jats:styled-content> units; approximately half completed therapy with 24\u2009\u00b1\u200923 phlebotomies (range, 1\u2010103). One\u2010third were lost to follow\u2010up. Overall, 15% had mild adverse effects, including headache, nausea, and dizziness, mainly during first phlebotomy. Prior transfusion burden correlated poorly with initial ferritin and total number of phlebotomies to target in the <jats:styled-content style=\"fixed-case\">TIO<\/jats:styled-content> group. However, number of phlebotomies to target was strongly correlated with initial <jats:styled-content style=\"fixed-case\">SF<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">R<\/jats:styled-content><jats:sup>2<\/jats:sup>\u2009=\u20090.8; p\u2009&lt;\u20090.0001) in both <jats:styled-content style=\"fixed-case\">TIO<\/jats:styled-content> and nontransfusional groups. <jats:styled-content style=\"fixed-case\">ALT<\/jats:styled-content> decreased significantly with serial phlebotomy in all groups (mean initial and final values, 61 and 39\u2009<jats:styled-content style=\"fixed-case\">U<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">L<\/jats:styled-content>; p\u2009=\u20090.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Initial <jats:styled-content style=\"fixed-case\">SF<\/jats:styled-content> but not transfusion burden predicted number of phlebotomies to target in patients with <jats:styled-content style=\"fixed-case\">TIO<\/jats:styled-content>. Despite good treatment tolerance, significant losses to follow\u2010up were noted. Providing patients with an estimated phlebotomy number and follow\u2010up duration, and thus a finite endpoint, may improve compliance. Hepatic function improved with iron offloading.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.12854","type":"journal-article","created":{"date-parts":[[2014,9,11]],"date-time":"2014-09-11T08:53:21Z","timestamp":1410425601000},"page":"611-622","source":"Crossref","is-referenced-by-count":7,"title":["Initial serum ferritin predicts number of therapeutic phlebotomies to iron depletion in secondary iron overload"],"prefix":"10.1111","volume":"55","author":[{"given":"Sandhya R.","family":"Panch","sequence":"first","affiliation":[{"name":"Hematology\/Transfusion Medicine National Heart, Lung and Blood Institute National Institutes of Health  Bethesda Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu Ying","family":"Yau","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine Clinical Center National Institutes of Health  Bethesda Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamille","family":"West","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine Clinical Center National Institutes of Health  Bethesda Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Diggs","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine Clinical Center National Institutes of Health  Bethesda Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamsen","family":"Sweigart","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine Clinical Center National Institutes of Health  Bethesda Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan F.","family":"Leitman","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine Clinical Center National Institutes of Health  Bethesda Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,9,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2006.00697.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2008.07361.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-01-261875"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2001.41060819.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1208500"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23417"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2004.03264.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2010.01.004"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-04-499772"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V90.3.994"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1995.tb08426.x"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1998.01099.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196812122792402"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1986.tb04071.x"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-0960.1988.tb01216.x"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2012.02794.x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12255"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1665-2681(19)30923-8"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcq170"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/2040620712458947"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21241"},{"key":"e_1_2_8_23_1","first-page":"41","article-title":"Congenital sideroblastic anemias","volume":"5","author":"Bottomley SS","year":"2006","journal-title":"Curr Hematol Rep"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminhematol.2009.07.001"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V93.5.1757"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.10313"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0929-693X(00)88740-0"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21986"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.23145"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.6.603"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2011.08.013"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199201093260204"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1053\/shem.2002.35636"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2007.01515.x"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-007-2095-z"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2011.01.053"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0046631"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2003.00570.x"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-553X.2007.00956.x"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8652(199805)58:1<16::AID-AJH3>3.0.CO;2-3"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2009.09.011"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2008.99"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-011-1358-1"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-013-1682-8"},{"key":"e_1_2_8_45_1","volume-title":"AABB technical manual","author":"Roback JD","year":"2011"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.12413"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-01-546333"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-200205000-00013"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2011.08590.x"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2004-10-3982"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200008033430503"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Ftrf.12854","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.12854","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T07:31:44Z","timestamp":1695540704000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.12854"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,9,11]]},"references-count":50,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2015,3]]}},"alternative-id":["10.1111\/trf.12854"],"URL":"https:\/\/doi.org\/10.1111\/trf.12854","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,9,11]]}}}