PMID- 35072269
OWN - NLM
STAT- MEDLINE
DCOM- 20220412
LR  - 20220412
IS  - 1537-2995 (Electronic)
IS  - 0041-1132 (Print)
IS  - 0041-1132 (Linking)
VI  - 62
IP  - 3
DP  - 2022 Mar
TI  - Procedural adverse events in pediatric patients with sickle cell disease 
      undergoing chronic automated red cell exchange.
PG  - 584-593
LID - 10.1111/trf.16807 [doi]
AB  - BACKGROUND: Chronic automated red cell exchange (RCE) is increasingly employed 
      for sickle cell disease (SCD). There is a paucity of data on the incidence of RCE 
      adverse events (AEs) and potential patient and procedural risk factors for AEs. 
      METHODS: A retrospective review of pediatric SCD patients receiving chronic RCE 
      over 3 years was performed to determine the frequency of AEs and identify 
      procedural and patient AE risk factors. AE incidence, AE rate, incidence rate 
      ratios (IRRs), and relative risks (RRs) were calculated based on various 
      procedural and patient characteristics by univariable (UV) and multivariable (MV) 
      analyses. RESULTS: In 38 patients receiving 760 procedures, there were 150 
      (19.7%) AEs, 36 (4.7%) were symptomatic AEs. AE rates were 20.2 [95% CI 17.2, 
      23.6] and 4.8 [95% CI 3.49, 6.70] per 100 person months for AEs and symptomatic 
      AEs, respectively. AE incidences were: hypocalcemia (117; 15.4%), dizziness (22; 
      3.0%), hypotension (15; 2.0%), and nausea (14; 1.8%). Patients with baseline Hct 
      >/=30% experienced more total AEs and symptomatic AEs. Patients with pre-procedure 
      systolic BP <50th percentile, severe CNS vasculopathy, and non-SCA genotype (HbSC 
      or Sbeta(+) thalassemia) exhibited more total AEs. IHD depletion was not associated 
      with an increased incidence of AEs or symptomatic AEs. CONCLUSION: SCD patients 
      with Hct >/=30%, systolic BP <50th percentile, severe CNS vasculopathy, and 
      possibly non-SCA genotype may be at higher risk for RCE-related AEs. The effect 
      of IHD on AE risk is likely minimal. Individualized AE risk assessment should be 
      performed in all SCD patients undergoing chronic automated RCE.
CI  - (c) 2022 AABB.
FAU - Wade, Jenna
AU  - Wade J
AD  - Center for Transfusion and Cellular Therapy, Department of Pathology and 
      Laboratory Medicine, Emory University, Atlanta, Georgia, USA.
AD  - Medical Sciences Institute, Blood Center of Wisconsin, Part of Versiti, 
      Milwaukee, Wisconsin, USA.
AD  - Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
FAU - Yee, Marianne E M
AU  - Yee MEM
AUID- ORCID: 0000-0001-6082-8385
AD  - Center for Transfusion and Cellular Therapy, Department of Pathology and 
      Laboratory Medicine, Emory University, Atlanta, Georgia, USA.
AD  - Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, 
      Atlanta, Georgia, USA.
AD  - Department of Pediatrics, Division of Hematology/Oncology, Emory University, 
      Atlanta, Georgia, USA.
FAU - Easley, Kirk A
AU  - Easley KA
AD  - Department of Biostatistics and Bioinformatics, Rollins School of Public Health, 
      Atlanta, Georgia, USA.
FAU - Pahz, Shannon
AU  - Pahz S
AD  - Department of Pathology, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
FAU - Butler, Hailly
AU  - Butler H
AD  - Center for Transfusion and Cellular Therapy, Department of Pathology and 
      Laboratory Medicine, Emory University, Atlanta, Georgia, USA.
FAU - Zerra, Patricia E
AU  - Zerra PE
AD  - Center for Transfusion and Cellular Therapy, Department of Pathology and 
      Laboratory Medicine, Emory University, Atlanta, Georgia, USA.
AD  - Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, 
      Atlanta, Georgia, USA.
AD  - Department of Pediatrics, Division of Hematology/Oncology, Emory University, 
      Atlanta, Georgia, USA.
FAU - Josephson, Cassandra D
AU  - Josephson CD
AUID- ORCID: 0000-0003-2543-991X
AD  - Center for Transfusion and Cellular Therapy, Department of Pathology and 
      Laboratory Medicine, Emory University, Atlanta, Georgia, USA.
AD  - Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, 
      Atlanta, Georgia, USA.
AD  - Department of Pediatrics, Division of Hematology/Oncology, Emory University, 
      Atlanta, Georgia, USA.
FAU - Fasano, Ross M
AU  - Fasano RM
AUID- ORCID: 0000-0001-8692-4041
AD  - Center for Transfusion and Cellular Therapy, Department of Pathology and 
      Laboratory Medicine, Emory University, Atlanta, Georgia, USA.
AD  - Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, 
      Atlanta, Georgia, USA.
LA  - eng
GR  - K23 HL146904/HL/NHLBI NIH HHS/United States
PT  - Journal Article
DEP - 20220124
PL  - United States
TA  - Transfusion
JT  - Transfusion
JID - 0417360
SB  - IM
MH  - *Anemia, Sickle Cell/therapy
MH  - Child
MH  - Erythrocytes
MH  - Humans
MH  - Incidence
MH  - Retrospective Studies
MH  - Risk Assessment
PMC - PMC8959247
MID - NIHMS1787625
COIS- Conflict of interest disclosure: The authors of this manuscript have no conflicts 
      of interest to disclose.
EDAT- 2022/01/25 06:00
MHDA- 2022/04/13 06:00
PMCR- 2022/03/28
CRDT- 2022/01/24 08:59
PHST- 2021/12/27 00:00 [revised]
PHST- 2021/09/15 00:00 [received]
PHST- 2021/12/27 00:00 [accepted]
PHST- 2022/01/25 06:00 [pubmed]
PHST- 2022/04/13 06:00 [medline]
PHST- 2022/01/24 08:59 [entrez]
PHST- 2022/03/28 00:00 [pmc-release]
AID - 10.1111/trf.16807 [doi]
PST - ppublish
SO  - Transfusion. 2022 Mar;62(3):584-593. doi: 10.1111/trf.16807. Epub 2022 Jan 24.