Role of Blood Transfusions in Sickle Cell Anemia

Transfusions play a large role in the management of sickle cell anemia; however, they are not considered standard of care for the management of anemia alone, states Thomas D. Coates, MD. Although transfusions can reduce pain associated with the anemia, they do not stop acute pain crisis. Moreover, transfusion can actually worsen this condition.

Transfusions are indicated for patients with sickle cell anemia to prevent the recurrence of severe complications, such as stroke. Blood transfusions can also stop the sickling that leads to acute chest syndrome. Both of these complications can be fatal, notes Coates.

Approximately one in four patients with sickle cell disease has a major stroke at some point in their life, Coates notes. The risk for stroke among children is approximately one in ten and can be predicted by measuring the blood flow velocity in the cerebral arterial circulation using transcranial Doppler. An elevated velocity predicts a 30% likelihood for having a stroke within three years, says Coates. Patients with frequent, severe crises may receive transfusions every three weeks to turn off the sickle hemoglobin production, reducing the risk for complications.