Time to rethink haemoglobin threshold guidelines in sickle cell disease.
Samir K BallasFrans A KuypersVictor R GordeukJane Silva HankinsAlexis A ThompsonElliott VichinskyPublished in: British journal of haematology (2021)
Alleviating anaemia in patients with sickle cell disease (SCD) is crucial in managing acute complications, mitigating end-organ damage and preventing early mortality. Some disease-modifying and curative therapies have increased haemoglobin (Hb) levels to exceed 100 g/l, a threshold above which complications from red blood cell (RBC) transfusions have occurred, raising concern about whole-blood viscosity-related complications with these therapies. Here we discuss the rationale behind this limit, the effect of viscosity on blood flow and the applicability of this Hb threshold to therapies for SCD beyond RBC transfusions.
Keyphrases
- red blood cell
- blood flow
- sickle cell disease
- risk factors
- end stage renal disease
- prognostic factors
- newly diagnosed
- chronic kidney disease
- liver failure
- oxidative stress
- clinical trial
- cardiovascular disease
- type diabetes
- drug induced
- clinical practice
- intensive care unit
- aortic dissection
- acute respiratory distress syndrome
- extracorporeal membrane oxygenation