title: Therapeutic phlebotomy is safe in children with sickle cell anaemia and can be effective treatment for transfusional iron overload.
abstract: Serial phlebotomy was performed on sixty children with sickle cell anaemia, stroke and transfusional iron overload randomized to hydroxycarbamide in the Stroke With Transfusions Changing to Hydroxyurea trial. There were 927 phlebotomy procedures with only 33 adverse events, all of which were grade 2. Among 23 children completing 30 months of study treatment, the net iron balance was favourable (-8·7 mg Fe/kg) with significant decrease in ferritin, although liver iron concentration remained unchanged. Therapeutic phlebotomy was safe and well-tolerated, with net iron removal in most children who completed 30 months of protocol-directed treatment.
authors.affiliation: Steven and Alexandra Cohen Children's Medical Center, New Hyde Park, NY, USA.
authors.forename: Banu
authors.initials: B
authors.lastname: Aygun
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Mortier
authors.forename: Karen
authors.initials: K
authors.lastname: Kesler
authors.forename: Alexandre
authors.initials: A
authors.lastname: Lockhart
authors.forename: William H
authors.initials: WH
authors.lastname: Schultz
authors.forename: Alan R
authors.initials: AR
authors.lastname: Cohen
authors.forename: Ofelia
authors.initials: O
authors.lastname: Alvarez
authors.forename: Zora R
authors.initials: ZR
authors.lastname: Rogers
authors.forename: Janet L
authors.initials: JL
authors.lastname: Kwiatkowski
authors.forename: Scott T
authors.initials: ST
authors.lastname: Miller
authors.forename: Pamela
authors.initials: P
authors.lastname: Sylvestre
authors.forename: Rathi
authors.initials: R
authors.lastname: Iyer
authors.forename: Peter A
authors.initials: PA
authors.lastname: Lane
authors.forename: Russell E
authors.initials: RE
authors.lastname: Ware
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005293:Ferritins / Q000378:metabolism; D006801:Humans; D007501:Iron / Q000378:metabolism; D019190:Iron Overload / Q000209:etiology* / Q000628:therapy*; D008099:Liver / Q000378:metabolism / Q000473:pathology; D008297:Male; D018962:Phlebotomy / Q000009:adverse effects / Q000379:methods; D065227:Transfusion Reaction; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005293:Ferritins; D007501:Iron
keywords: iron overload; liver iron; phlebotomy; sickle cell