![]() Additionally, alloimmunized patients had poorer survival (hazard ratio, 1.92 p = 0.01) and were more likely to have avascular necrosis (p = 0.024), end-organ damage (p = 0.049), and red blood cell autoantibodies (p < 0.001), even after controlling for the effects of age, sex, and hemoglobin diagnosis. ![]() Although alloimmunization was not associated with frequency of vasoocclusive episodes, a higher percentage of alloimmunized patients had chronic pain, as defined by daily use of short-acting narcotics (p = 0.006), long-acting narcotics (p = 0.013), or both (p = 0.03). Alloantibody specificities differed from those previously described, especially due to the significantly higher frequency of anti-S. Differences in demographic, clinical, and laboratory findings end-organ damage and overall disease severity were then compared between alloimmunized and nonalloimmunized patients.ResultsOf 319 patients, 87 (27%) were alloimmunized. Historical records of patients with SCD at two participating institutions were reviewed for data on antigen phenotype and alloimmunization. We explored whether alloimmunization is associated with disease severity in SCD.Study Design and MethodsĪdult SCD patients were enrolled in a study of outcome-modifying genes in SCD. The study underscores the need for the development and dissemination of comprehensive sickle cell transfusion guidelines and protocols.Īlloimmunization remains a significant complication of transfusion and has been associated with multiple factors, including inflammation, an important pathophysiologic mechanism in sickle cell disease (SCD). Analysis of clinical vignette data revealed variation among hematologists/oncologists in the transfusion management of common clinical scenarios. There were statistically significant differences for pediatric and adult-oriented practices in managing certain acute and chronic transfusion indications. The majority of pediatric practices (60%) had individually defined transfusion practice guidelines in contrast to 8% of adult-oriented practices. The majority of survey respondents did not request limited phenotypically matched red blood cells on a routine basis. Pediatric practices had a larger percentage of patients with overt strokes, and receiving hydroxyurea therapy than adult-oriented practices. Non-academic practice settings (78 %) were the primary location. One hundred fifty two physicians (75% adult-oriented, 25% pediatric) completed the survey. The survey instrument addressed practice characteristics, sickle cell patient populations, transfusion settings, indications and techniques, red blood cell phenotype specifications/modifications, use of practice guidelines, and educational resource utilization. A cross-sectional study was performed in 2005-2006 utilizing a mail survey. ![]() The purpose of this study was to characterize transfusion practices in the management of sickle cell disease and to identify factors attributing to differences in prescribing practices among Florida hematologists/oncologists.
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