Red blood cell transfusion therapy for sickle cell patients with frequent painful events

Pediatric Blood & Cancer
Lee M HilliardJeffrey D Lebensburger

Abstract

Recurrent pain events or chronic pain are among the most common complications of sickle cell disease. Despite attempts to maximize adherence to and dosing of hydroxyurea, some patients continue to suffer from pain. Our institution developed a program to initiate chronic red blood cell transfusions for one year in patients clinically deemed to have high healthcare utilization from sickle cell pain, despite being prescribed hydroxyurea. An institutional review board approved retrospective study to evaluate the health outcomes associated with a one-year red blood cell transfusion protocol in sickle cell patients experiencing recurrent pain events as compared with the health outcomes for these patients in the one year prior to receiving transfusion therapy. We performed a matched-pair analysis using a Wilcoxon signed rank to determine the impact of transfusion therapy on clinic visits, emergency department visits, hospital admissions, hospitalization days, and opioid prescriptions filled. One year of transfusion therapy significantly reduced the number of total emergency department visits for pain (6 vs 2.5 pain visits/year, P = 0.005), mean hospitalizations for pain (3.4 vs 0.9 pain admissions/year), and mean hospital days per yea...Continue Reading

References

Jul 19, 2013·American Journal of Hematology·Ofelia AlvarezUNKNOWN Investigators of the Stroke With Transfusions Changing to Hydroxyurea Clinical Trial (SWiTCH)
Aug 21, 2014·The New England Journal of Medicine·Michael R DeBaunJames F Casella
Oct 28, 2014·American Journal of Hematology·Lauren M BeverungUNKNOWN SIT trial investigators
Apr 29, 2015·JAMA : the Journal of the American Medical Association·Nicolas StettlerNancy B Walczak
May 16, 2015·Pediatric Blood & Cancer·Amanda M BrandowJulie A Panepinto
May 20, 2015·Journal of Opioid Management·Wally R SmithSusan D Roseff
Dec 14, 2016·The New England Journal of Medicine·Kenneth I AtagaRussell P Rother
Feb 22, 2017·Pain·Amanda M BrandowCheryl L Stucky
Jun 13, 2017·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Dimitris A TsitsikasRoger J Amos
Sep 16, 2017·American Journal of Hematology·Jeremie H EsteppJane S Hankins
Sep 26, 2017·The Journal of Pain : Official Journal of the American Pain Society·Patrick H FinanJennifer A Haythornthwaite

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Citations

Oct 1, 2019·Current Opinion in Hematology·Matthew S Karafin, Joshua J Field
Aug 30, 2019·Journal of Clinical Psychology in Medical Settings·Anna M HoodDesiree A White
Apr 14, 2021·Scientific Reports·Mario GutierrezOmolola Eniola-Adefeso

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