Delayed hemolytic transfusion reaction in children with sickle cell disease: first 5-year retrospective study in mainland France

Falguière, Claire; Allali, Slimane; Khazem, Bassem; Kamdem, Annie; Belloy, Marie; Guitton, Corinne; Odièvre, Marie‐Hélène; Pertuisel, Sophie; Dumesnil, C.; Guillaumat, Cécile; Garrec, Nathalie; Gauthier, Alexandra; Mahe, Perrine; Soussan-Banini, Valerie; Le-Carrer, Laure; Merlin, Étienne; David, Audrey; Pellegrino, B.; Paillard, Catherine; Brasme, Jean-François; Lagarde, Marie; Pirenne, France; Pondarré, Corinne

doi:10.3324/haematol.2022.281050

Cited by 7 publications

(23 citation statements)

References 16 publications

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“…This study, describing 41 children with SCD with DHTR, is the largest paediatric cohort of this rare complication. [8][9][10] In most patients, DHTR occurred in an inflammatory context, such as acute events or surgeries, as described in the literature. [5][6][7][8]10 Nonetheless, in 17% of patients, DHTR occurred within a chronic RBC transfusion programme, with no inflammatory event.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6] Most studies have described DHTR in adult patients and only a few small paediatric cohorts have been reported. [6][7][8][9][10] DHTR manifests as painful crisis (PC) and haemolysis with dark urine and jaundice. 6,7,10 DHTR is frequently followed by an ACS, kidney or liver failure and an increased risk of mortality (~10%).…”

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confidence: 99%

“…[6][7][8][9][10] DHTR manifests as painful crisis (PC) and haemolysis with dark urine and jaundice. 6,7,10 DHTR is frequently followed by an ACS, kidney or liver failure and an increased risk of mortality (~10%). 6,7 Several risk factors for DHTR have been identified in a prospective study in adults, and include history of DHTR, alloimmunisation or low number of RBC transfusions.…”

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confidence: 99%

“…6,7 Several risk factors for DHTR have been identified in a prospective study in adults, and include history of DHTR, alloimmunisation or low number of RBC transfusions. 5 Antibody screening is positive in 50%-60% of cases, 6,7,10 frequently with antibodies of unclear significance. 7,10 Although the pathophysiology is not fully understood, identification of alloantibodies suggests involvement of the immune system 4 and complement activation.…”

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confidence: 99%

“…5 Antibody screening is positive in 50%-60% of cases, 6,7,10 frequently with antibodies of unclear significance. 7,10 Although the pathophysiology is not fully understood, identification of alloantibodies suggests involvement of the immune system 4 and complement activation. [11][12][13][14] According to recently published guidelines, 15 if anaemia is well tolerated, RBC transfusion should be avoided due to the risk of exacerbating haemolysis.…”

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confidence: 99%

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Delayed haemolytic transfusion reaction in paediatric patients with sickle cell disease: A retrospective study in a French national reference centre

et al. 2022

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Summary Delayed haemolytic transfusion reaction (DHTR) is a life‐threatening haemolytic anaemia following red blood cell transfusion in patients with sickle cell disease, with only scarce data in children. We retrospectively analysed 41 cases of DHTR in children treated between 2006 and 2020 in a French university hospital. DHTR manifested at a median age of 10.5 years, symptoms occurred a median of 8 days after transfusion performed for an acute event (63%), before surgery (20%) or in a chronic transfusion programme (17%). In all, 93% of patients had painful crisis. Profound anaemia (median 49 g/L), low reticulocyte count (median 140 ×109/L) and increased lactate dehydrogenase (median 2239 IU/L) were observed. Antibody screening was positive in 51% of patients, and more frequent when there was a history of alloimmunisation. Although no deaths were reported, significant complications occurred in 51% of patients: acute chest syndrome (12 patients), cholestasis (five patients), stroke (two patients) and kidney failure (two patients). A further transfusion was required in 23 patients and corticosteroids were used in 21 to reduce the risk of additional haemolysis. In all, 13 patients subsequently received further transfusions with recurrence of DHTR in only two. The study affords a better overview of DHTR and highlights the need to establish guidelines for its management in children.

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Delayed haemolytic transfusion reaction in paediatric patients with sickle cell disease: A retrospective study in a French national reference centre

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Rapid haemoglobin A and S quantification using Tosoh HLC‐723G8 in variant mode for patients with sickle cell disease

Fadel,

Noyelle,

Maingon

et al. 2023

Biomedical Chromatography

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The management of life‐threatening complications in patients with sickle cell disease (SCD) requires an accurate and reproducible quantification of haemoglobin A (HbA) and S (HbS) with a short turnaround time and 24‐7 availability. We propose a novel method for quantifying HbA and HbS using the glycated haemoglobin (HbA1c) assay on a Tosoh HLC‐723G8 (G8) analyser in variant mode. HbA and HbS results obtained using our method highly correlated with results obtained using a reference method (r > 0.99 for 124 samples of patients with SCD or sickle cell trait). Our method met laboratory requirements for linearity (coefficient of variation [CV] and bias <5%), between‐run and within‐run reproducibility (CV <10%) and carryover (<0.5%) over the range of HbS and HbA values expected in a therapeutic context. Using the G8 analyser in variant mode is viable for monitoring HbA and HbS concentrations in dire situations. This method is easy to use, quick (1.6 min per sample), and automatable and produces highly reproducible results without significant bias. Finally, it does not require modifications to the analytical pipeline recommended by the supplier, enabling a 24‐7 availability without disrupting routine monitoring of HbA1c in the laboratory.

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La drépanocytose : une transfusion à risque

Pirenne

2024

Bulletin de l'Académie Nationale de Médecine

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Delayed hemolytic transfusion reaction in children with sickle cell disease: first 5-year retrospective study in mainland France

Abstract: Not available.

Cited by 7 publications

References 16 publications

Delayed haemolytic transfusion reaction in paediatric patients with sickle cell disease: A retrospective study in a French national reference centre

Delayed haemolytic transfusion reaction in paediatric patients with sickle cell disease: A retrospective study in a French national reference centre

Rapid haemoglobin A and S quantification using Tosoh HLC‐723G8 in variant mode for patients with sickle cell disease

La drépanocytose : une transfusion à risque

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