Monthly blood transfusions could cut down stroke risk in young individuals suffering from sickle cell anemia.
About one in every three children suffering from sickle cell anemia have a "silent stroke," or a loss of blood flow to the brain, Washington University School of Medicine reported. These incidents usually go unnoticed but can damage the individual's IQ levels. A new study showed monthly blood transfusions reduced recurring strokes in these patients by 58 percent.
"The data make transfusion the only evidence-based option to prevent stroke recurrence and further brain injury in this vulnerable population," said coauthor Michael Noetzel, MD, professor of neurology and of pediatrics and chair of the study's neurology committee. "Now that we have identified a viable treatment option, early detection of silent cerebral strokes should become a major focus for clinicians and families of children with sickle cell disease."
The researcher recommended children with sickle cell anemia should be checked for silent strokes by the time they start elementary school. If an MRI scan reveals these strokes have occurred the patient should consider monthly blood transfusions.
Sickle cell anemia is characterized by crescent-shaped red blood cells, making them less effective at transporting oxygen around the body; the cells can also clump together, leading to a blockage. Debris from these cells could clog brain vessels, resulting in a stroke.
To make their findings the researchers looked at 196 patients between the ages of five and 15 who suffered from sickle cell anemia and already had strokes. The team gave 99 of those children monthly blood transfusions for three years. The children who received the transfusions were found to statistically significantly less likely to suffer additional strokes.
"We think the transfusions are helping because they raise the total amount of circulating blood and lower the percentage of sickle-shaped cells in the patient's bloodstream," said coauthor Allison King, MD, assistant professor of pediatrics and of occupational therapy. "Keeping the sickled cells to less than 30 percent of total blood cells seems to be ideal."
Possible complications from these transfusions include: " infections, allergic reactions to the donated blood and long-term buildup of excessive iron in the bloodstream from multiple transfusions, which can damage the heart and liver," the university reported.
The findings were published Aug. 20 in The New England Journal of Medicine.
