TY - JOUR TI - Beta thalassemia minor is a beneficial determinant of red blood cell storage lesion AU - Tzounakas, Vassilis L. AU - Anastasiadi, Alkmini T. AU - Stefanoni, Davide AU - and Cendali, Francesca AU - Bertolone, Lorenzo AU - Gamboni, Fabia and AU - Dzieciatkowska, Monika AU - Rousakis, Pantelis AU - Vergaki, Athina and AU - Soulakis, Vassilis AU - Tsitsilonis, Ourania E. AU - Stamoulis, AU - Konstantinos AU - Papassideri, Issidora S. AU - Kriebardis, Anastasios G. AU - and D'Alessandro, Angelo AU - Antonelou, Marianna H. JO - Haematologica-the hematology journal PY - 2022 VL - 107 TODO - 1 SP - 112-125 PB - Ferrata Storti Foundation SN - null TODO - 10.3324/haematol.2020.273946 TODO - null TODO - Blood donor genetics and lifestyle affect the quality of red blood cell (RBC) storage. Heterozygotes for beta thalassemia (beta Thal(+)) constitute a non-negligible proportion of blood donors in the Mediterranean and other geographical areas. The unique hematological profile of beta Thal(+) could affect the capacity of enduring storage stress, however, the storability of beta Thal(+) RBC is largely unknown. In this study, RBC from 18 beta Thal(+) donors were stored in the cold and profiled for primary (hemolysis) and secondary (phosphatidylserine exposure, potassium leakage, oxidative stress) quality measures, and metabolomics, versus sex- and age-matched controls. The beta Thal(+) units exhibited better levels of storage hemolysis and susceptibility to lysis following osmotic, oxidative and mechanical insults. Moreover, beta Thal(+) RBC had a lower percentage of surface removal signaling, reactive oxygen species and oxidative defects to membrane components at late stages of storage. Lower potassium accumulation and higher urate-dependent antioxidant capacity were noted in the beta Thal(+) supernatant. Full metabolomics analyses revealed alterations in purine and arginine pathways at baseline, along with activation of the pentose phosphate pathway and glycolysis upstream to pyruvate kinase in beta Thal(+) RBC. Upon storage, substantial changes were observed in arginine, purine and vitamin B6 metabolism, as well as in the hexosamine pathway. A high degree of glutamate generation in beta Thal(+) RBC was accompanied by low levels of purine oxidation products (IMP, hypoxanthine, allantoin). The beta Thal mutations impact the metabolism and the susceptibility to hemolysis of stored RBC, suggesting good post-transfusion recovery. However, hemoglobin increment and other clinical outcomes of beta Thal(+) RBC transfusion deserve elucidation by future studies. ER -