Delayed hemolytic transfusion reaction in children with sickle cell disease

Montalembert, Mariane de; Dumont, M; Heilbronner, Claire; Brousse, Valentine; Charrara, O.; Pellegrino, B.; Piguet, Christophe; Soussan, V.; Noizat‐Pirenne, F.

doi:10.3324/haematol.2010.038307

Cited by 92 publications

(122 citation statements)

References 27 publications

(41 reference statements)

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“…40 It is not uncommon for DHTRs to occur in patients with SCD in the absence of a detectable antibody or a positive DAT. 41,42 DTRs can also occur without overt clinical signs of hemolysis 39 and posttransfusion screening tests may be negative. 42 Hyperhemolysis syndrome is a severe complication described in patients with SCD in which the patient's hemoglobin drops lower than the pretransfusion hemoglobin, suggesting hemolysis of autologous RBCs in addition to donor RBCs.…”

Section: Dtrsmentioning

confidence: 99%

“…41,42 DTRs can also occur without overt clinical signs of hemolysis 39 and posttransfusion screening tests may be negative. 42 Hyperhemolysis syndrome is a severe complication described in patients with SCD in which the patient's hemoglobin drops lower than the pretransfusion hemoglobin, suggesting hemolysis of autologous RBCs in addition to donor RBCs. Possible mechanisms of hyperhemolysis syndrome include bystander hemolysis, suppression of erythropoiesis, and RBCs being destroyed by activated macrophages.…”

Section: Dtrsmentioning

confidence: 99%

“…In cases of hyperhemolysis syndrome, further transfusion may exacerbate ongoing hemolysis, so individual management is dependent on the severity of anemia and the rapidity of hemolysis. 42,43 In less severe cases, transfusion may be avoided with close monitoring and the patient should be treated with corticosteroids with or without IVIg. In cases of severe hemolysis and hyperhemolysis, the patient will likely require transfusion and corticosteroids and IVIg should be used in conjunction.…”

Section: Dtrsmentioning

confidence: 99%

See 2 more Smart Citations

Transfusion therapy for sickle cell disease: a balancing act

Chou

2013

Hematology

108

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Transfusion therapy is a key intervention in decreasing morbidity and mortality in patients with sickle cell disease (SCD). Current indications for acute and chronic transfusion therapy have significantly increased the number of RBC units transfused to patients with SCD worldwide. This review summarizes transfusion management for the treatment or prevention of neurologic and perioperative complications, acute chest syndrome, and acute anemia associated with SCD. Despite the recognized benefits of transfusion therapy, it is not without the risks of iron overload, alloimmunization, and delayed hemolytic transfusion reactions. Transfusional iron overload management includes automated RBC exchange, noninvasive imaging to monitor iron burden, and iron chelation with parenteral or oral agents. Although limited and extended RBC antigen matching reduces antibody formation, the prevalence of RBC alloimmunization in patients with SCD remains high. Recent studies demonstrate that RH genetic diversity in patients with SCD contributes to Rh alloimmunization, suggesting that even more refined RBC matching strategies are needed. Advances in molecular blood group typing offer new opportunities to improve RBC matching of donors and recipients and can be of particular benefit to patients with SCD.

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Section: Dtrsmentioning

confidence: 99%

Section: Dtrsmentioning

confidence: 99%

Section: Dtrsmentioning

confidence: 99%

See 1 more Smart Citation

Transfusion therapy for sickle cell disease: a balancing act

Chou

2013

Hematology

108

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“…Ibrutinib is currently approved for the treatment of patients with relapsed CLL or CLL with del(17p), relapsed mantle cell lymphoma, and Waldenström macroglobulinemia. [2][3][4][5][6] Major toxicities of ibrutinib include bleeding, fatigue, arthralgia, infection, and atrial fibrillation. 7,8 One prior case of ibrutinib-associated pneumonitis has been reported.…”

Section: To the Editormentioning

confidence: 99%

“…In about one-third of DHTR cases, there are no detectable antibodies. 5,6 No optimal treatment of DHTR has yet been defined. One possible approach is to minimize intravascular hemolysis and the side effects of free hemoglobin on the endothelium by inhibiting complement activation.…”

mentioning

confidence: 99%