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Blood transfusion for preventing primary and secondary stroke in people with sickle cell disease.
CONCLUSIONS: The STOP trial demonstrated a significantly reduced risk of stroke in participants with abnormal transcranial Doppler ultrasonography velocities receiving regular blood transfusions. The follow-up trial (STOP 2) indicated that individuals may revert to former risk status if transfusion is discontinued. The degree of risk must be balanced against the burden of chronic transfusions. The combination of hydroxyurea and phlebotomy is not as effective as "standard" transfusion and chelation in preventing secondary stroke and iron overload. Ongoing multicentre trials are investigating the use of chronic transfusion t...
Source: Cochrane Database of Systematic Reviews - November 14, 2013 Category: Journals (General) Authors: Wang WC, Dwan K Tags: Cochrane Database Syst Rev Source Type: research

Venous and Arterial Viscosity-associated Thrombosis in Hemoglobin SC Disease
I read with interest the article of Naik et al highlighting the risk of venous thrombosis in patients suffering from sickle cell disease. However, the authors may have missed the opportunity to address an important issue by studying separately sickle cell anemia and hemoglobin SC patients whose clinical presentation, pathogenesis, treatment and evolution are quite different. Hemoglobin SC patients usually are not anemic or only mildly anemic, and hyperviscosity plays a key role in the pathogenesis of complications observed in this disease. We showed in a recent study that life-threatening complication observed in hemoglo...
Source: The American Journal of Medicine - September 25, 2013 Category: Journals (General) Authors: François Lionnet Tags: Letters Source Type: research

Pain and other non‐neurological adverse events in children with sickle cell anemia and previous stroke who received hydroxyurea and phlebotomy or chronic transfusions and chelation: Results from the SWiTCH clinical trial
Conclusions: In children with SCA and prior stroke, monthly transfusions and daily iron chelation provided superior protection against acute vaso‐occlusive pain SAEs when compared to hydroxyurea and monthly phlebotomy.
Source: American Journal of Hematology - July 16, 2013 Category: Hematology Authors: Ofelia Alvarez, Nancy A. Yovetich, J. Paul Scott, William Owen, Scott T. Miller, William Schultz, Alexandre Lockhart, Banu Aygun, Jonathan Flanagan, Melanie Bonner, Brigitta U. Mueller, Russell E. Ware, Tags: Research Article Source Type: research

Reduction of iron stores and clinical outcomes in peripheral arterial disease: outcome comparisons in smokers and non-smokers.
Abstract A prospective randomized trial suggested that iron (ferritin) reduction improved outcomes in smokers. The present study reanalyzed the trial results in smokers compared with non-smokers. Randomization of 1262 men with peripheral arterial disease (540 smokers and 722 non-smokers) to iron reduction (phlebotomy) or control groups permitted analysis of the effects of iron reduction and smoking on primary (all-cause mortality) and secondary (death plus non-fatal myocardial infarction or stroke) endpoints. Iron reduction resulted in significant improvement in the primary (hazard ratio [HR] 0.661, 95% confidence...
Source: Vascular - March 21, 2013 Category: Surgery Authors: Depalma RG, Zacharski LR, Chow BK, Shamayeva G, Hayes VW Tags: Vascular Source Type: research

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