Annals of Hematology

, Volume 97, Issue 10, pp 1909–1917 | Cite as

Red blood cells metabolome changes upon treatment with different X-ray irradiation doses

  • Fabio Baroni
  • Chiara Marraccini
  • Lucia Merolle
  • Vando Piccagli
  • Daniele Lambertini
  • Mauro IoriEmail author
  • Tommaso Fasano
  • Emanuela Casali
  • Alberto Spisni
  • Roberto Baricchi
  • Thelma A. Pertinhez
Original Article


The upholding of red blood cells (RBC) quality and the removal of leukocytes are two essential issues in transfusion therapy. Leukodepletion provides optimum results, nonetheless there are cases where irradiation is recommended for some groups of hematological patients such as the ones with chronic graft-vs-host disease, congenital cellular immunodeficiency, and hematopoietic stem cell transplant recipients. The European guidelines suggest irradiation doses from 25 to 50 Gray (Gγ). We evaluated the effect of different prescribed doses (15 to 50 Gγ) of X-ray irradiation on fresh leukodepleted RBCs bags using a novel protocol that provides a controlled irradiation. Biochemical assays integrated with RBCs metabolome profile, assessed by nuclear magnetic resonance spectroscopy, were performed on RBC units supernatant, during 14 days storage. Metabolome analysis evidenced a direct correlation between concentration increase of three metabolites, glycine, glutamine and creatine, and irradiation dose. Higher doses (35 and 50 Gγ) effect on RBC mean corpuscular volume, hemolysis, and ammonia concentration are considerable after 7 and 14 days of storage. Our data show that irradiation with 50 Gγ should be avoided and we suggest that 35 Gγ should be the upper limit. Moreover, we suggest for leukodepleted RBCs units the irradiation with the prescribed dose of 15 Gγ, value at center of bag, and ranging between 13.35–15 Gγ, measured over the entire bag volume, may guarantee the same benefits of a 25 Gγ dose assuring, in addition, a better quality of RBCs.


NMR metabolomics Ammonium X-ray irradiation RBC metabolome Bone marrow transplant Leukemia 



Bone marrow transplant


Graft-versus-host disease


Mean corpuscular volume


Nuclear magnetic resonance


Reactive oxygen species


Red blood cell


Compliance with ethical standards

The study was approved by the Arcispedale Santa Maria Nuova (ASMN)-IRCCS Ethics Committee on July 1, 2016.

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of informed consent

Informed consent was obtained from all patients for being included in the study.

Supplementary material

277_2018_3386_MOESM1_ESM.docx (127 kb)
ESM 1 (DOCX 127 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Fabio Baroni
    • 1
    • 2
  • Chiara Marraccini
    • 1
  • Lucia Merolle
    • 1
  • Vando Piccagli
    • 3
  • Daniele Lambertini
    • 3
  • Mauro Iori
    • 3
    Email author
  • Tommaso Fasano
    • 4
  • Emanuela Casali
    • 5
  • Alberto Spisni
    • 5
  • Roberto Baricchi
    • 1
  • Thelma A. Pertinhez
    • 1
    • 5
  1. 1.Transfusion Medicine UnitAUSL–IRCCSReggio EmiliaItaly
  2. 2.Department of Protein ChemistryMerckRomeItaly
  3. 3.Medical Physics UnitAUSL–IRCCSReggio EmiliaItaly
  4. 4.Clinical and Endocrinology LaboratoryAUSL–IRCCSReggio EmiliaItaly
  5. 5.Department of Medicine and SurgeryUniversity of ParmaParmaItaly

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