Chronic Blood Transfusion Therapy Practices to Treat Strokes in Children with Sickle Cell Disease

Abstract

A wide range of local standard care guidelines for blood transfusion therapy exists. The results of this survey indicate that partial manual exchange transfusion is the most commonly used method of chronic blood transfusion therapy in children with SCD and stroke despite the fact that the magnitude of benefit in comparison with simple transfusion has not been established. Factors such as peripheral venous access, compliance with current chelation regimen, and the presence of antibodies are important considerations in the choice of method.

Physicians’ Opinion on the Practice of Exchange Blood Transfusion for Treatment of Stroke in Sickle Cell Anaemia

“…This was also observed by Lindsey T, et al [22] who noted that manual exchange blood transfusion is what is available in most hematology programs. This is probably due to cost of machinery required for automated exchange.…”

Erythrocytapheresis for chronic transfusion therapy in sickle cell disease: survey of current practices and review of the literature

“…This is in contrast to a survey from 2005 of nine institutions with 189 pediatric patients who received chronic transfusions in which manual exchange was actually the most common method (66% manual, 21% simple, and 13% aRBX). 33 Ware reviewed 3543 transfusions administered to 295 pediatric patients who received CTT in 2006 and reported that 56% of transfusions were simple, 20% were manual exchange, 17% were aRBX, and 7% included multiple methods. 34 Assuming that similar types of institutions were surveyed among the various studies, the use of aRBX appears to be increasing.…”

How I treat and manage strokes in sickle cell disease

“…2 Given the benefits of a less positive iron store with exchange transfusion (manual or automated), we strongly prefer this strategy to simple blood transfusions for regular blood transfusion therapy. At the very least, when possible, we perform a manual exchange, 58,59 that is available to most hematology programs. 58 Hydroxyurea therapy for secondary stroke prevention Unique circumstances may prohibit regular blood transfusion therapy as a strategy for secondary prevention of strokes.…”

“…At the very least, when possible, we perform a manual exchange, 58,59 that is available to most hematology programs. 58 Hydroxyurea therapy for secondary stroke prevention Unique circumstances may prohibit regular blood transfusion therapy as a strategy for secondary prevention of strokes. Although hydroxyurea therapy is not as effective as regular blood transfusion therapy for secondary stroke prevention, 60 this is a reasonable alternative when compared with no therapy at all.…”