• Skip to main content
  • Skip to primary sidebar
Transfusion News
  • About Us
  • Topics
    • Adverse Events (non-infectious)
    • Blood Donation
    • Cell Therapy
    • Coagulation & Plasma Transfusion
    • Platelet Transfusion
    • Policy and Guidelines
    • Quality Control and Regulatory
    • RBC Transfusion
    • Serology/Genotyping
    • Special Transfusion Situations
    • Transfusion Transmitted Infections
  • Continuing Education
  • Archives
  • Podcasts
  • Question of the Day
  • Search
  • Subscribe to Email Alerts
  • Follow us on
  • Search
  • Subscribe to Email Alerts

New Assessment Criteria to Diagnose and Manage Delayed Hemolytic Transfusion Reactions in Sickle Cell Patients

May 23, 2018

Many patients with sickle cell disease (SCD) require chronic transfusions and are at risk for life-threatening delayed hemolytic transfusion reactions (DHTRs). The diagnosis of DHTR is often difficult because antibodies against the transfused RBCs are often undetectable and symptoms can mimic vaso-occlusive events.  Presently, there are no existing guidelines or evidence-based studies to guide the prevention, diagnosis, and treatment of DHTR.  In order to provide some guidance, doctors at a French hospital shared their expertise and assessment criteria to diagnose and treat DHTRs in SCD patients.   They have devised a DHTR risk score for patients receiving episodic transfusions based on three criteria—history of RBC alloimmunization, number of previous transfusions, and previous DHTRs.  They recommend transfusing matching Rh and K RBCs in SCD patients with a low risk of DHTR and extending matching to Fy, Jk and Ss in higher risk patients.  If DHTR is suspected, they have devised a nomogram based on post-transfusion total Hb and HbA% to help diagnosis DHTR.  They also recommend prophylactic rituximab for high risk patients or DHTR patients requiring transfusions.  Intravenous immunoglobulin, erythropoietin, high-dose steroids, eculizumab, and plasma exchange may also be tailored for individual DHTR treatment.  However, additional studies for the prevention, diagnosis, treatment of DHTR are critically needed.

Reference:

  1. Pirenne F and K Yazdanbakhsh. How I safely transfuse patients with sickle cell disease and manage delayed hemolytic transfusion reactions. Blood 2018; doi.org/10.1182/blood-2018-02-785964

Filed Under

  • Adverse Events (non-infectious)
  • News

Recommended

  • Increasing Data Available for Plasma Transfusion Indications

  • Intrinsic Platelet Reactivity does not Affect Transfusion Outcome

  • Using Machine Learning Models to Predict the Likelihood of a Transfusion

Show Comments

Reader Interactions

Comments

  1. Tarren-Leigh Baartzes says

    June 18, 2018 at 6:02 am

    The issue with treating SCD, rests purely on the chronic transfusions. Due to multiple transfusions, the patient is exposed to multiple antibodies which likely go under detected due to the state of the patient plus the list of medication that has been taken. Should a more synthetic/artificial blood product be used to treat these patients, it would lessen the exposure to foreign bodies and also the process would be less life-threatening for the patient.

Comments on this article are closed.

Get the latest news. Subscribe to our mailing list. Sign Up

Primary Sidebar

Latest News

  • New Erythropoietin Gene Variants Linked to Hereditary Erythrocytosis

  • Multifaceted Threats to the Blood Supply from Climate Change

  • Distinct Roles for Differently Aged Platelets

  • Anemia Treatment Bundle Improves Hemoglobin Recovery after Critical Illness

    Question of the Day

    Copyright © 2025 John Wiley & Sons, Inc. All Rights Reserved.
    Privacy Policy

    Association for the Advancement of Blood and Biotherapies Wiley