Clinical and laboratory observationExchange blood transfusion compared with simple transfusion for first overt stroke is associated with a lower risk of subsequent stroke: A retrospective cohort study of 137 children with sickle cell anemia
Section snippets
Methods
The eligibility criteria, data collection, and study methods have been described previously.2 Patients were identified at 14 medical centers, and their records were reviewed between 1998 and 2000. Institutional review board approval was obtained according to guidelines at the participating centers. Patients were included in the analysis if they had sickle cell anemia (SCA) and had undergone at least 5 years of chronic blood transfusion therapy after stroke. Exclusion criteria were lack of
Patient Population
The participating institutions identified 164 children with SCA, a history of stroke, and at least 5 years of blood transfusion therapy. Of these, 137 met all inclusion criteria; 46% were male. The mean age at initial stroke was 6.3 years (range, 1.4 to 14 years), and the mean follow-up was 10.1 years (range, 5 to 24 years). Initial strokes occurred between May 1972 and March 1995. In this cohort, 31 of the 137 patients (23%) had a recurrent stroke while receiving chronic blood transfusion
Discussion
We have demonstrated that the proportion of children treated with exchange transfusion for acute strokes has increased since the procedure was first described by Lusher et al in 19763 and that this treatment is now the most common method of initial therapy for acute stroke. In addition, we have provided preliminary evidence indicating that initial exchange transfusion is associated with a decreased risk of second strokes.
Given the retrospective nature of this study, we can only postulate why
References (6)
- et al.
Risk of recurrent stroke in children with sickle cell disease receiving blood transfusion therapy for at least five years after initial stroke
J Pediatr
(2002) - et al.
Longitudinal changes in brain magnetic resonance imaging findings in children with sickle cell disease
Blood
(2002) - et al.
The natural history of stroke in sickle cell disease
Am J Med
(1978)
Cited by (0)
Supported by the Doris Duke and Robert Wood Johnson Foundations and the National Institutes of Health (training grant 5T32HD4301003).