Red blood cell transfusions during sickle cell anemia vaso-occlusive crises: a report from the magnesium in crisis (MAGiC) study

Transfusion
Monica L HulbertPediatric Emergency Care and Research Network Sickle Cell Disease Working Group

Abstract

Little is known about red blood cell (RBC) transfusion practices for children hospitalized for a sickle cell vaso-occlusive pain crisis (VOC). We hypothesized that transfusion would be associated with the development of acute chest syndrome (ACS), lower hemoglobin (Hb) concentration, and lack of hydroxyurea therapy. This is a secondary analysis of all children admitted for a sickle cell pain crisis enrolled in the Magnesium in Crisis (MAGiC) randomized trial; all had HbSS or S-β0thalassemia. ACS development and transfusion administration were prospectively collected during the parent trial. All Hb values during the hospitalization were recorded, as was parent report of child receiving hydroxyurea. Relative risks (RRs) of transfusion were compared between groups. Of 204 enrolled children, 40 (19.6%) received a transfusion. Of the 30 children who developed ACS, 22 (73.3%) received transfusions compared to 18 of 174 (10.3%) without ACS: the RR of transfusion in children with ACS was 7.1 (95% confidence interval [CI], 4.4-11.5). Among those without ACS, the lowest Hb was most strongly associated with transfusions: RR was 3.1 (95% CI 2.0 - 4.7) for each 1 g/dL decrease in lowest Hb. In a binary recursive partitioning model for those...Continue Reading

References

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Apr 3, 2012·British Journal of Haematology·Lori StylesUNKNOWN Sickle Cell Disease Clinical Research Network (SCDCRN)
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Jul 19, 2013·American Journal of Hematology·Ofelia AlvarezUNKNOWN Investigators of the Stroke With Transfusions Changing to Hydroxyurea Clinical Trial (SWiTCH)
Jan 21, 2014·Pediatric Blood & Cancer·Oluwakemi Badaki-MakunUNKNOWN Pediatric Emergency Care Applied Research Network (PECARN) Magnesium in Sickle Cell Crisis (MAGiC) Study Group
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Citations

Sep 10, 2019·The Cochrane Database of Systematic Reviews·Nan Nitra ThanLucia De Franceschi

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