OBJECTIVES

To avoid and overcome significant sickle cell disease (SCD) complications, treating physicians have different therapeutic options including several chronic transfusion modalities such as simple blood transfusion (ST), manual blood exchange procedure (MBE) or automated red blood cell exchange procedure (RBCX). The objective of this study was to determine the impact of different blood transfusion modalities and their ability to avoid and overcome SCD patient complications.

METHODS

The main study method was physician reported patient health outcomes. The study relied on a double blinded cross-sectional survey amongst 53 treating physicians based in the US. Together, these physicians yearly routinely treat 5,989 SCD patients out of an estimated total population of 100,000 SCD patients in the US. The impact of chronic blood transfusion modalities on SCD complications was measured on 14 disease complications.

RESULTS

Chronic automated RBCX largely outperformed simple blood transfusion and manual blood exchange in terms of SCD patient complication reduction. Complication reduction for RBCX was found to be 56% higher versus manual exchange and 46% higher vs simple blood transfusion. Compared to the next best transfusion alternative (simple transfusion or manual exchange) RBCX was reported to have a significantly (p < 0.01) positive impact (% reduction) on the following disease complications: acute chest syndrome (-24%), stroke (-45%), silent infarction (-54%), renal failure (-38%), priapism (-62%), iron overload (-50%) and severe infection (-32%).

CONCLUSIONS

Automated RBCX is likely to reduce the incidence of multiple SCD complications. Physicians access to multiple transfusion modalities at their facility will decrease the patient burden of disease and potential long-term consequences of SCD most by utilizing automated RBCX whenever possible.