Imbalance of Globin Chain Synthesis in Newborn Infants with Hemolytic Disease after Exchange Transfusion

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Abstract
The relative rates of .beta.-, .gamma.- and .alpha.-globin chain formation in reticulocytes of 6 newborn infants with hemolytic disease were determined before and in weekly intervals after exchange transfusion. Directly after birth (before exchange transfusion) the .beta./.alpha., .gamma./.alpha. and (.beta. + .gamma.)/.alpha. ratios in newborn infants with hemolytic disease (0.35 .+-. 0.20, 0.67 .+-. 0.12 and 1.06 .+-. 0.29) were similar to those of normal newborn infants (0.33 .+-. 0.07, 0.65 .+-. 0.06 and 0.98 .+-. 0.06). The gradual increase in the .beta./.alpha. ratio seen during the postnatal period of 8 normal newborn infants was also observed in newborn infants with hemolytic disease after exchange transfusion. In contrast, the .gamma./.alpha. ratio was increased (1.89 .+-. 0.25) in all infants with hemolytic disease in the 2nd wk after exchange transfusion. The corresponding value for normal newborn infants was 0.48 .+-. 0.25. After exchange transfusion the number of Hb F-containing erythrocytes increased. Possible reasons for this imbalance of globin chain formation after exchange transfusion may be the decreased erythropoiesis and/or the abnormal high Hb A concentration after exchange transfusion or the introduction of an unknown, .gamma. chain formation-stimulating agent by exchange transfusion.

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