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Time to rethink haemoglobin threshold guidelines in sickle cell disease
Author(s) -
Ballas Samir K.,
Kuypers Frans A.,
Gordeuk Victor R.,
Hankins Jane S.,
Thompson Alexis A.,
Vichinsky Elliott
Publication year - 2021
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.17578
Subject(s) - medicine , disease , blood viscosity , red cell , red blood cell , intensive care medicine , blood transfusion , hemoglobinopathy , immunology
Summary 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.