Change of RBC Deformability During Hematopoietic Stem Cell Transplantation, Kim & Lee, 2021

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Change of RBC Deformability During Hematopoietic Stem Cell Transplantation
Kim YK, Lee JM

Abstract
The red blood cell (RBC) deformability test is the measurement of the ability of RBCs to adapt their shape to the flow conditions. The major determinants of RBC deformability include cell shape, composition of the cell membrane and cytoskeleton, and internal viscosity (mean cell hemoglobin concentration). RBC deformability is primarily regulated by the composition and arrangement of the cell membrane.

In cancer patients, chemotherapy and hematopoietic stem transplantation (HSCT) affect the bone marrow microenvironment, which may alter RBC production and deformability. We aimed to evaluate the change in RBC deformability during HSCT.

Blood samples were obtained from patients who underwent HSCT. Eleven children were enrolled in this study. RBC deformability was measured with a microfluidic ektacytometer (RheoScan-D, RheoMeditech, Seoul, Korea). All analyses were completed within 24 hours after blood collection.

The elongation index of the erythrocytes was measured. The elongation index of RBCs gradually increased from day 5 to day 30 after HSCT. RBC deformability may reflect the bone marrow microenvironment of the patient during HSCT. Further studies investigating the correlation between RBC deformability and the prognosis of HSCT are needed.

PubMed
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They used a microfluidic ektacytometer and found:

As time passed, the shear stress is decreased and the shape of the RBCs gradually changed from an ellipsoid to a biconcave morphology

They concluded:

The mechanism underlying the increased RBC deformability during HSCT is not completely understood. However, oxidative stress could be considered one of the factors affecting the rheological properties of RBCs during cancer, chemotherapy, and hematopoietic stem cell transplantation. After stem cell infusion, the erythropoiesis of the recipient decreased and that of the donor began. That is, RBCs that were not damaged by oxidative stress began to be produced. It is assumed that this is the cause of the change in RBC deformability.

 

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Linking back to the potentially related thread on Orthostatic intolerance syndromes after hematopoietic cell transplantation.