PMID- 32579245
OWN - NLM
STAT- MEDLINE
DCOM- 20210621
LR  - 20210621
IS  - 1537-2995 (Electronic)
IS  - 0041-1132 (Linking)
VI  - 60
IP  - 8
DP  - 2020 Aug
TI  - Blood utilization and characteristics of patients treated with chronic 
      transfusion therapy in a large cohort of Brazilian patients with sickle cell 
      disease.
PG  - 1713-1722
LID - 10.1111/trf.15818 [doi]
AB  - BACKGROUND: 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.
CI  - (c) 2020 AABB.
FAU - Kelly, Shannon
AU  - Kelly S
AUID- ORCID: 0000-0003-2049-3992
AD  - Vitalant Research Institute, San Francisco, California, USA.
AD  - UCSF Benioff Children's Hospital Oakland, Oakland, California, USA.
FAU - Belisario, Andre Rolim
AU  - Belisario AR
AUID- ORCID: 0000-0003-0166-4258
AD  - Fundacao Hemominas/Minas Gerais Hemocenter, Minas Gerais, Brazil.
FAU - Werneck Rodrigues, Daniela O
AU  - Werneck Rodrigues DO
AD  - Fundacao Hemominas/Minas Gerais Hemocenter, Minas Gerais, Brazil.
FAU - Carneiro-Proietti, Anna B F
AU  - Carneiro-Proietti ABF
AD  - Fundacao Hemominas/Minas Gerais Hemocenter, Minas Gerais, Brazil.
FAU - Goncalez, Thelma T
AU  - Goncalez TT
AD  - Vitalant Research Institute, San Francisco, California, USA.
FAU - Loureiro, Paula
AU  - Loureiro P
AD  - Hemope/University of Pernambuco, Recife, Pernambuco, Brazil.
FAU - Flor-Park, Miriam V
AU  - Flor-Park MV
AD  - Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, 
      Instituto da Crianca, Sao Paulo, Brazil.
FAU - Maximo, Claudia
AU  - Maximo C
AD  - Hemorio, Rio de Janeiro Hemocenter, Rio de Janeiro, Brazil.
FAU - Mota, Rosimere Afonso
AU  - Mota RA
AD  - Vitalant Research Institute, San Francisco, California, USA.
FAU - Dinardo, Carla
AU  - Dinardo C
AUID- ORCID: 0000-0002-0453-7863
AD  - Pro-Sangue, Sao Paulo Hemocenter, Sao Paulo, Brazil.
AD  - Institute of Tropical Medicine, University of Sao Paulo, Sao Paulo, Brazil.
FAU - Brambilla, Don
AU  - Brambilla D
AUID- ORCID: 0000-0002-7276-4689
AD  - Research Triangle Institute (RTI) International, Triangle Park, North Carolina, 
      USA.
FAU - Preiss, Liliana
AU  - Preiss L
AD  - Research Triangle Institute (RTI) International, Triangle Park, North Carolina, 
      USA.
FAU - Sabino, Ester
AU  - Sabino E
AUID- ORCID: 0000-0003-2623-5126
AD  - Institute of Tropical Medicine, University of Sao Paulo, Sao Paulo, Brazil.
FAU - Custer, Brian
AU  - Custer B
AD  - Fundacao Hemominas/Minas Gerais Hemocenter, Minas Gerais, Brazil.
AD  - Department of Laboratory Medicine, University of California at San Francisco, San 
      Francisco, California, USA.
CN  - NHLBI Recipient Epidemiology Donor Evaluation Study (REDS-III) International 
      Component-Brazil
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
DEP - 20200624
PL  - United States
TA  - Transfusion
JT  - Transfusion
JID - 0417360
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - *Acute Chest Syndrome/blood/epidemiology/therapy
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - Brazil/epidemiology
MH  - Child
MH  - Child, Preschool
MH  - Erythrocyte Transfusion/*adverse effects
MH  - Female
MH  - Humans
MH  - *Iron Overload/blood/epidemiology/etiology
MH  - Male
MH  - Oxygen/*blood
MH  - Sex Factors
MH  - *Transfusion Reaction/blood/epidemiology
EDAT- 2020/06/25 06:00
MHDA- 2021/06/22 06:00
CRDT- 2020/06/25 06:00
PHST- 2019/04/15 00:00 [received]
PHST- 2020/01/13 00:00 [revised]
PHST- 2020/01/13 00:00 [accepted]
PHST- 2020/06/25 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2020/06/25 06:00 [entrez]
AID - 10.1111/trf.15818 [doi]
PST - ppublish
SO  - Transfusion. 2020 Aug;60(8):1713-1722. doi: 10.1111/trf.15818. Epub 2020 Jun 24.