Risk of recurrent stroke in patients with sickle cell disease treated with erythrocyte transfusions

• Published in: The Journal of pediatrics 1995-06, Vol.126 (6), p.896-899
• Main Authors: Pegelow, Charles H., Adams, Robert J., McKie, Virgil, Abboud, Miguel, Berman, Brian, Miller, Scott T., Olivieri, Nancy, Vichinsky, Elliott, Wang, Winfred, Brambilla, Donald
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anemia, Sickle Cell - therapy; Anemias. Hemoglobinopathies; Biological and medical sciences; Cerebral Infarction - etiology; Cerebral Infarction - prevention & control; Cerebrovascular Disorders - etiology; Cerebrovascular Disorders - prevention & control; Child; Child, Preschool; Diseases of red blood cells; Erythrocyte Transfusion; Female; Hematologic and hematopoietic diseases; Hemoglobin, Sickle - analysis; Humans; Infant; Male; Medical sciences; Recurrence
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/S0022-3476(95)70204-0

Objective: To determine the effect of a transfusion program on risk of stroke recurrence in children with sickle cell disease. Design: The clinical course and experience with transfusion therapy at eight centers were reviewed for subjects whose initial stroke occurred after January 1988. Results: Sixty subjects were observed for 191.7 patient-years. Eight had a single recurrent stroke (two intracranial hemorrhages and six infarctions) for a prevalence of 13.3%, or one recurrence for each 24 patient-years of observation. Thirteen subjects had 15 transient neurologic events; two of these had subsequent strokes, but the overall risk was similar for those who did and those did not have transient events. Hemoglobin S levels were greater than the desired maximum of 30% at the time of 7 of 16 transient events and five of six recurrent infarctions. The stroke recurrence rate was similar to those in previous reports of children receiving long-term transfusion therapy but significantly less than that reported for children who did not receive transfusions (p