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122 RED BLOOD CELL MORPHOLOGY IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD): EFFECT OF OXYGEN THERAPY VERSUS ALLOPURINOL

Morphologic abnormalities in red blood cells depend on diverse factors which may include the intracellular centent of oxygen. Hypoxemia increases adenine nucleotide turnover and may influence erythrocyte morphology. To test this hypothesis in 7 patients with clinically stable COPD we measured red cell ATP (iATP) levels by HPLC and observed erythrocyte morphology by scanning electron microscopy. Studies were carried out in 3 situations: basal state (mean±SEM; PaO2, 58±3 mm Hg), after 7 days on oxygen therapy (PaO2, 79±4 mm Hg; P<0.01) and following a 7 day course on allopurinol (300 mg/24 h; PaO2, 58±3 mm Hg). iATP concentrations were similar in the 3 experimental conditions. However, significant differences were observed with respect to the distribution of discocytes, stomatocytes and sphero-stomatocytes. Stomacocytes decreased markedly from a mean base-line number of 23.8% of total red cells to 12.0% on oxygen therapy (P<0.001) and to 14.5% on allopurinol (P<0.001). These data indicate that hypoxemia promotes red cell morphologic alterations that do not depend on iATP levels. Short-term allopurinol administration to COPD patients decreases morphologically abnormal cells by reducing the production of stomatocytes to a level similar to that observed with oxygen therapy.