title: Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload.
abstract: Children with sickle cell anemia (SCA) may be at risk of cerebral vasculopathy and strokes, which can be prevented by chronic transfusion programs. Repeated transfusions of packed red blood cells (PRBCs) is currently the simplest and most used technique for chronic transfusion programs. However, iron overload is one of the major side effects of this therapy. More developed methods exist, notably the apheresis of RBC (erythrapheresis), which is currently the safest and most efficient method. However, it is costly, complicated, and cannot be implemented everywhere, nor is it suitable for all patients. Manual exchange transfusions combine one or more manual phlebotomies with a PRBC transfusion. At the Reference Center of Sickle Cell Disease, we set up a continuous method of manual exchange transfusion that is feasible for all hospital settings, demands no specific equipment, and is widely applicable. In terms of HbS decrease, stroke prevention, and iron overload prevention, this method showed comparable efficiency to erythrapheresis. In cases where erythrapheresis is not available, this method can be a good alternative for patients and care centers.
authors.affiliation: Reference Centre of Sickle Cell Disease, Hematology Unit, Robert Debré Hospital, AP-HP; berengere.koehl@inserm.fr.
authors.forename: Bérengère
authors.initials: B
authors.lastname: Koehl
authors.affiliation: Reference Centre of Sickle Cell Disease, Hematology Unit, Robert Debré Hospital, AP-HP.
authors.forename: Florence
authors.initials: F
authors.lastname: Missud
authors.affiliation: Reference Centre of Sickle Cell Disease, Hematology Unit, Robert Debré Hospital, AP-HP.
authors.forename: Laurent
authors.initials: L
authors.lastname: Holvoet
authors.affiliation: Reference Centre of Sickle Cell Disease, Hematology Unit, Robert Debré Hospital, AP-HP.
authors.forename: Ghislaine
authors.initials: G
authors.lastname: Ithier
authors.affiliation: School of Pharmacy, Université Paris Descartes.
authors.forename: Oliver
authors.initials: O
authors.lastname: Sakalian-Black
authors.affiliation: Reference Centre of Sickle Cell Disease, Hematology Unit, Robert Debré Hospital, AP-HP.
authors.forename: Zinedine
authors.initials: Z
authors.lastname: Haouari
authors.affiliation: Etablissement Français du Sang, Robert Debré Hospital, AP-HP.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Lesprit
authors.affiliation: Hematology Unit,, Robert Debré Hospital, AP-HP, Univsité Paris Diderot.
authors.forename: André
authors.initials: A
authors.lastname: Baruchel
authors.affiliation: Reference Centre of Sickle Cell Disease, Hematology Unit, Robert Debré Hospital, AP-HP.
authors.forename: Malika
authors.initials: M
authors.lastname: Benkerrou
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000628:therapy*; D001803:Blood Transfusion; D002648:Child; D017707:Erythrocyte Transfusion; D005078:Exchange Transfusion, Whole Blood / Q000379:methods*; D006801:Humans; D019190:Iron Overload / Q000517:prevention & control*; D008297:Male; D018962:Phlebotomy; D017713:Platelet Transfusion