Time to rethink haemoglobin threshold guidelines in sickle cell disease
Samir K. Ballas, Frans A. Kuypers, Victor R. Gordeuk, Jane S. Hankins, Alexis A. Thompson, Elliott Vichinsky
Abstract
Alleviating anaemia in patients with sickle cell disease (SCD) is crucial in managing acute complications, mitigating end-organ damage and preventing early mortality. Some disease-modifying and curative therapies have increased haemoglobin (Hb) levels to exceed 100 g/l, a threshold above which complications from red blood cell (RBC) transfusions have occurred, raising concern about whole-blood viscosity-related complications with these therapies. Here we discuss the rationale behind this limit, the effect of viscosity on blood flow and the applicability of this Hb threshold to therapies for SCD beyond RBC transfusions.
Topics & Concepts
MedicineDiseaseBlood viscosityRed CellRed blood cellIntensive care medicineBlood transfusionHemoglobinopathyInternal medicineImmunologyHemoglobinopathies and Related DisordersBlood groups and transfusionErythrocyte Function and Pathophysiology