Effect of long-term transfusion on growth in children with sickle cell anemia: results of the STOP trial.
OBJECTIVE
To determine whether long-term transfusion improves growth in children with sickle cell anemia.


METHODS
In the Stroke Prevention Trial for Sickle Cell Anemia Study, patients were randomized to receive long-term transfusion (CTX) or standard care (STC). Transfusions were administered every 3 to 5 weeks, and hemoglobin S levels were maintained at 30% pretransfusion for an average of 2 years. Serial height and weight measurements (obtained every 3 months), body mass index (BMI) values, and growth z-scores were analyzed.


RESULTS
Children in the CTX (n=53) and STC (n=41) groups were similar at baseline. After 24 months, the z-scores for height, weight, and BMI of those receiving CTX had improved significantly, whereas no changes occurred in the STC group. Patients in the CTX group approached normal height-for-age and weight-for-age z-scores. Patients from a large historical control group had significantly lower weight and height growth velocities than patients in the CTX group.


CONCLUSIONS
Patients in the Stroke Prevention Trial for Sickle Cell Anemia Study who received CTX had improved height and weight and BMI over a 2-year period. Higher hemoglobin levels resulting from transfusion may improve growth by lowering energy expenditure. In addition to the prevention of vasoocclusive events, CTX results in significant improvement in the growth of children with sickle cell disease.
Wang
Winfred C
WC
St. Jude Children's Research Hospital, Memphis, Tenn 38105, USA. winfred.wang@stjude.org
Morales
Knashawn H
KH
Scher
Charles D
CD
Styles
Lori
L
Olivieri
Nancy
N
Adams
Robert
R
Brambilla
Don
D
D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D000986:Antisickling Agents / Q000627:therapeutic use; D001803:Blood Transfusion; D001827:Body Height; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D006128:Growth; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use; D016014:Linear Models; D020521:Stroke / Q000209:etiology / Q000517:prevention & control
D000986:Antisickling Agents; D006918:Hydroxyurea