Blood utilization and characteristics of patients treated with chronic transfusion therapy in a large cohort of Brazilian patients with sickle cell disease

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorKELLY, Shannon
dc.contributor.authorBELISARIO, Andre Rolim
dc.contributor.authorRODRIGUES, Daniela O. Werneck
dc.contributor.authorCARNEIRO-PROIETTI, Anna B. F.
dc.contributor.authorGONCALEZ, Thelma T.
dc.contributor.authorLOUREIRO, Paula
dc.contributor.authorV, Miriam Flor-Park
dc.contributor.authorMAXIMO, Claudia
dc.contributor.authorMOTA, Rosimere Afonso
dc.contributor.authorDINARDO, Carla
dc.contributor.authorBRAMBILLA, Don
dc.contributor.authorPREISS, Liliana
dc.contributor.authorSABINO, Ester
dc.contributor.authorCUSTER, Brian
dc.contributor.groupauthorNHLBI Recipient Epidemiology Donor
dc.date.accessioned2020-10-15T14:35:39Z
dc.date.available2020-10-15T14:35:39Z
dc.date.issued2020
dc.description.abstractBACKGROUND Red blood cell (RBC) transfusions are used in sickle cell disease (SCD) to treat acute complications or as chronic transfusion therapy (CTT) to prevent severe manifestations. The objectives of this study were to describe blood utilization and adverse events (AEs) associated with RBCs in the Brazilian SCD population and compare characteristics of patients treated or not with CTT. STUDY DESIGN AND METHODS A SCD cohort was established at six Brazilian centers. Medical and blood bank records were abstracted for clinical and transfusion history. Two controls not treated with CTT matched on center, SCD genotype, sex, and age were selected for each CTT case within the cohort to compare characteristics between the two groups. RESULTS Most of the 2794-member cohort had received a transfusion (75.0% of children and 89.2% of adults) with 29.2% of patients receiving transfusion in the prior year. There were 170 (10.6%) children and 115 (9.2%) adults treated with CTT. Children not treated with CTT were more likely to have pain and acute chest hospitalizations in the prior year (25.3% vs. 11.9%, p = 0.0003; and 22.0% vs. 10.7%, p = 0.002, respectively). Both iron overload and alloimmunization were more common in CTT cases compared to controls (65.6% vs. 17.0% and 36.2% vs. 15.9%, respectively). A higher proportion of adults treated with CTT demonstrated oxygen saturation of greater than 95% compared to controls not treated (51.1% vs. 39.2%), while there was no difference in oxygenation between children treated or not. Of 4501 transfusion episodes, 28 (0.62%) AEs were reported. There was no difference in AEs associated with transfusions for acute indications versus CTT. CONCLUSION Red blood cell transfusion was common in Brazilian SCD patients, with utilization driven by CTT. Transfusion reactions were not common; however, alloimmunization and iron overload were frequent among those on CTT, highlighting the need for novel clinical strategies to mitigate these risks.eng
dc.description.indexMEDLINEeng
dc.identifier.citationTRANSFUSION, v.60, n.8, p.1713-1722, 2020
dc.identifier.doi10.1111/trf.15818
dc.identifier.eissn1537-2995
dc.identifier.issn0041-1132
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/37761
dc.language.isoeng
dc.publisherWILEYeng
dc.relation.ispartofTransfusion
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright WILEYeng
dc.subject.otherstroke-prevention trialeng
dc.subject.otheriron overloadeng
dc.subject.otheroxygen-saturationeng
dc.subject.otherrisk-factorseng
dc.subject.otherchildreneng
dc.subject.otheralloimmunizationeng
dc.subject.otherhemoglobineng
dc.subject.otheranemiaeng
dc.subject.othererythrocytapheresiseng
dc.subject.otherprevalenceeng
dc.subject.wosHematologyeng
dc.titleBlood utilization and characteristics of patients treated with chronic transfusion therapy in a large cohort of Brazilian patients with sickle cell diseaseeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.affiliation.countryEstados Unidos
hcfmusp.affiliation.countryisous
hcfmusp.author.externalKELLY, Shannon:Univ Calif San Francisco, Vitalant Res Inst, San Francisco, CA 94143 USA; UCSF Benioff Childrens Hosp Oakland, Oakland, CA USA
hcfmusp.author.externalBELISARIO, Andre Rolim:Fundacao Hemominas, Minas Gerais Hemoctr, Belo Horizonte, MG, Brazil
hcfmusp.author.externalRODRIGUES, Daniela O. Werneck:Fundacao Hemominas, Minas Gerais Hemoctr, Belo Horizonte, MG, Brazil
hcfmusp.author.externalCARNEIRO-PROIETTI, Anna B. F.:Fundacao Hemominas, Minas Gerais Hemoctr, Belo Horizonte, MG, Brazil
hcfmusp.author.externalGONCALEZ, Thelma T.:Univ Calif San Francisco, Vitalant Res Inst, San Francisco, CA 94143 USA
hcfmusp.author.externalLOUREIRO, Paula:Univ Pernambuco, Hemope, Recife, PE, Brazil
hcfmusp.author.externalMAXIMO, Claudia:Rio de Janeiro Hemoctr, Hemorio, Rio De Janeiro, Brazil
hcfmusp.author.externalMOTA, Rosimere Afonso:Univ Calif San Francisco, Vitalant Res Inst, San Francisco, CA 94143 USA
hcfmusp.author.externalBRAMBILLA, Don:Res Triangle Inst RTI Int, Res Triangle Pk, NC USA
hcfmusp.author.externalPREISS, Liliana:Res Triangle Inst RTI Int, Res Triangle Pk, NC USA
hcfmusp.author.externalCUSTER, Brian:Univ Calif San Francisco, Dept Lab Med, San Francisco, CA USA; Fundacao Hemominas, Minas Gerais Hemoctr, Belo Horizonte, MG, Brazil
hcfmusp.citation.scopus4
hcfmusp.contributor.author-fmusphcMIRIAM VERONICA FLOR PARK
hcfmusp.contributor.author-fmusphcCARLA LUANA DINARDO
hcfmusp.contributor.author-fmusphcESTER CERDEIRA SABINO
hcfmusp.description.beginpage1713
hcfmusp.description.endpage1722
hcfmusp.description.issue8
hcfmusp.description.volume60
hcfmusp.origemWOS
hcfmusp.origem.pubmed32579245
hcfmusp.origem.scopus2-s2.0-85087150013
hcfmusp.origem.wosWOS:000542403500001
hcfmusp.publisher.cityHOBOKENeng
hcfmusp.publisher.countryUSAeng
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