Journal article
Using the daily rate of rise in hemoglobin S to manage RBC depletion/exchange treatment in sickle cell disease
Transfusion (Philadelphia, Pa.), Vol.64(4), pp.685-692
04/2024
DOI: 10.1111/trf.17797
PMID: 38506484
Appears in UI Libraries Support Open Access
Abstract
Red blood cell exchange is often used prophylactically in patients with sickle cell disease, with the goal to maintain hemoglobin S (HbS) below a target threshold level. We reviewed whether the daily "rate of rise" (RoR) in HbS that occurs between procedures can be used for patient management. For some patients not achieving their HbS goals despite efficient exchanges, the post-procedure hematocrit (Hct) target is increased to potentially suppress HbS production. This case series explores the utility of this approach, other clinical uses of the daily RoR in HbS, and the factors that influence it.
A total of 660 procedures from 24 patients undergoing prophylactic RBC depletion/exchange procedures were included. Laboratory values and clinical parameters were collected and used to calculate the daily RoR in HbS. Factors such as Hct or medications that might influence the RoR in HbS were evaluated.
The RoR in HbS varied widely between patients but remained relatively stable within individuals. Surprisingly, this value was not significantly influenced by changes in post-procedure Hct or concurrent hydroxyurea use. A patient's average RoR in HbS effectively predicted the pre-procedure HbS at the following visit (R
= 0.65).
The RoR in HbS is a relatively consistent parameter for individual patients that is unaffected by medication use or procedural Hct targets and may be useful in determining intervals between procedures.
Details
- Title: Subtitle
- Using the daily rate of rise in hemoglobin S to manage RBC depletion/exchange treatment in sickle cell disease
- Creators
- Kai Rogers - University of Iowa Health CareMouaz Alsawas - University of IowaJames Chapman - University of IowaAnnette J Schlueter - University of IowaCharles Michael Knudson - University of Iowa Health Care
- Resource Type
- Journal article
- Publication Details
- Transfusion (Philadelphia, Pa.), Vol.64(4), pp.685-692
- Publisher
- Wiley
- DOI
- 10.1111/trf.17797
- PMID
- 38506484
- eISSN
- 1537-2995
- Language
- English
- Electronic publication date
- 03/20/2024
- Date published
- 04/2024
- Academic Unit
- Microbiology and Immunology; Pathology; Radiation Oncology
- Record Identifier
- 9984573951802771
Metrics
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