Iron Depletion in Repeat Male Plateletpheresis Donors: Prevalence and Associated Factors in a Cross-Sectional Study

Purpose: Iron depletion is increasingly recognized among repeat plateletpheresis donors despite the return of red blood cells during apheresis. However, data on iron status and factors associated with reduced iron stores in plateletpheresis donors in Thailand remain limited. This study aimed to determine the prevalence of iron depletion and identify factors associated with lower iron stores among repeat plateletpheresis donors. Patients and Methods: This cross-sectional study included healthy, non-anemic male repeat plateletpheresis donors at a university hospital blood bank in Thailand. Donors were categorized into three groups according to serum ferritin levels: iron depletion (≤ 30 μg/L), intermediate iron stores (31– 100 μg/L), and higher iron stores (> 100 μg/L). Demographic characteristics, donation history, hematologic parameters, and iron indices were evaluated. Factors associated with iron depletion were explored using univariable logistic regression, whereas factors associated with ferritin ≤ 100 μg/L were evaluated using univariable and multivariable logistic regression. Results: Among 150 participants, iron depletion was identified in 6 donors (4.0%; 95% CI, 1.5– 8.5%), 42 had intermediate iron stores (28.0%; 95% CI, 21.0– 35.9%), and 102 donors had ferritin > 100 μg/L (68.0%; 95% CI, 59.9– 75.4%). Platelet donation frequency, platelet donation volume during the preceding year, lifetime platelet donations, and recent whole blood donation were not significantly associated with either ferritin threshold. In multivariable analysis, body weight (adjusted OR, 0.963; 95% CI, 0.929– 0.998; p=0.036) and reticulocyte count (OR, 0.205; 95% CI, 0.066– 0.637; p=0.006) were independently associated with ferritin ≤ 100 μg/L. Conclusion: Iron depletion was uncommon, but one-third of non-anemic repeat plateletpheresis donors had ferritin ≤ 100 μg/L. Lower body weight and lower reticulocyte count were associated with this ferritin threshold in exploratory analyses. Prospective studies are required to confirm these findings before targeted iron-status screening strategies can be recommended.