The aim of this study was to evaluate the extent of endogenous carbon monoxide production in subjects with ineffective erythropoiesis. Carboxyhaemoglobin concentrations were measured in eight transfused and eight nontransfused thalassemic patients. Measurements were made on venous blood collected under controlled conditions and were corrected by simultaneous measurement of HbF levels. Nontransfused thalassaemic patients with abnormal erythropoiesis were found to have elevated levels of carboxyhaemoglobin, significantly higher than those found in transfused subjects, as well as decreased cardiac performance. It is important to consider carboxyhaemoglobin levels in planning transfusion programmes.
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