A randomized clinical trial published in The New England Journal of Medicine, observed children (5-15 years old) with sickle cell anemia and at least one silent cerebral infarct with no abnormalities. Each participant received either standard care (N=97) or a monthly blood transfusion (N=99). After a median follow-up period of three years, 14% of the observation group and 6% of the transfusion group had either a stroke or a new or enlarged silent cerebral infarct. Although regular blood transfusions significantly reduced the risk of strokes or recurrent silent cerebral infarcts, transfusion reactions and alloantibody formation occurred at least 4 times more often in the transfusion group compared to the observation group. More research is needed to identify children with sickle cell anemia who stand to benefit the most from regular blood transfusions.
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