title: Safety, tolerability, and outcomes of regular automated red cell exchange transfusion in the management of sickle cell disease.
abstract: We report here our experience with regular automated red cell exchange transfusion for the management of chronic complications of sickle cell disease in 50 patients in our institution from June 2011 to December 2014. The mean sickle hemoglobin level was 44% and 8.5% pre- and post-transfusion, respectively. Platelets were reduced by a mean 70% during the procedure with a count of less than 50 × 109/l in 6% of cases. The alloimmunization rate was 0.065/100 units of red cells with no hemolytic reactions. Patients with no iron overload at baseline showed no evidence of iron accumulation with a mean liver iron concentration of 1.6 mg/g dry tissue and 1.9 mg/g dry tissue at baseline and 36 months, respectively. All six patients with pre-existing iron overload and on chelation therapy, showed a gradual reduction of their liver iron concentration and two patients could discontinue chelation during the follow-up period. Seventy percentage of patients who were on the programme for recurrent painful crises showed a sustained reduction in the number of emergency hospital attendances; the mean number of days in hospital for emergency treatment was 103 in the year prior to commencing ARCET and reduced to 62 (40%) after the first 12 months, 51 (50%) after 24 months, and 35 days (66%) after 36 months. J. Clin. Apheresis 31:545-550, 2016. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Heamoglobinopathy Service, Department of Haematology, Homerton University Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Dimitris A
authors.initials: DA
authors.lastname: Tsitsikas
authors.affiliation: Heamoglobinopathy Service, Department of Haematology, Homerton University Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Bala
authors.initials: B
authors.lastname: Sirigireddy
authors.affiliation: Heamoglobinopathy Service, Department of Haematology, Homerton University Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Ruben
authors.initials: R
authors.lastname: Nzouakou
authors.affiliation: Heamoglobinopathy Service, Department of Haematology, Homerton University Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Alexander
authors.initials: A
authors.lastname: Calvey
authors.affiliation: Heamoglobinopathy Service, Department of Haematology, Homerton University Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Joanne
authors.initials: J
authors.lastname: Quinn
authors.affiliation: Heamoglobinopathy Service, Department of Haematology, Homerton University Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Janine
authors.initials: J
authors.lastname: Collins
authors.affiliation: Heamoglobinopathy Service, Department of Haematology, Homerton University Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Funmilayo
authors.initials: F
authors.lastname: Orebayo
authors.affiliation: Heamoglobinopathy Service, Department of Haematology, Homerton University Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Natasha
authors.initials: N
authors.lastname: Lewis
authors.affiliation: Heamoglobinopathy Service, Department of Haematology, Homerton University Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Sophie
authors.initials: S
authors.lastname: Todd
authors.affiliation: Heamoglobinopathy Service, Department of Haematology, Homerton University Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Roger J
authors.initials: RJ
authors.lastname: Amos
mesh_terms: D000755:Anemia, Sickle Cell / Q000628:therapy*; D001331:Automation; D019468:Disease Management; D017707:Erythrocyte Transfusion / Q000379:methods / Q000592:standards*; D006801:Humans; D007501:Iron / Q000378:metabolism; D007902:Length of Stay; D010146:Pain; D061214:Patient Safety; D010976:Platelet Count; D016896:Treatment Outcome
chemical_list: D007501:Iron
keywords: ARCET; iron overload; sickle cell disease