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Red blood cell exchange in children with sickle cell disease

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Abstract

The aim of our study was to assess the efficacy of red blood cell exchange (RBCx) using a Spectra Optia® automated apheresis system in children with sickle cell disease (SCD). We used automated RBCx to treat acute and chronic complications in 75 children with SCD who had a median age of 10 years [7–13]. We analyzed 649 RBCx sessions. Peripheral venous access was limited in a number of the children, and thus a femoral double-lumen central venous catheter was required. We recommend heparin locking with 500 units in each lumen of the catheter. To prevent complications, we ensured that all patients had achieved a post-RCE HbS level of < 30%. For chronic transfusion, with a post-RCE Hb level of approximately 10–11 g/dL, a blood exchange volume of ≥ 32 mL/kg, and an interval between each RBCx procedure of ≤ 30 days, the residual HbS level was maintained below 30%. For acute transfusion, a post-exchange Hb level ≥ 10 g/dL (p < 0.001) and a total exchange volume ≥ 35 mL/kg (p = 0.001) were the best way to reduce HbS to < 30%. AUC was 0.84. Our results show that erythrocytapheresis was useful and safe for children with SCD.

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Acknowledgements

The authors would like to thank Pr Mathieu NACHER from the INSERM U1424 of Cayenne Hospital, Rue des flamboyants, BP 6006, 97306 Cayenne Cedex, French Guiana, for his advice and corrections.

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There is no funding related to this study.

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Authors and Affiliations

  1. Sickle Cell Disease Center, Centre Hospitalier de Cayenne, Rue des Flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana

    Narcisse Elenga & Vincent Vantilcke

  2. Centre Hospitalier de Cayenne, Rue des Flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana

    Narcisse Elenga, Elise Martin, Emma Cuadro & Thierry Basset

  3. Etablissement Français du Sang, Andrée Rosemon, Rue des Flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana

    Pierre Selles

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  1. Narcisse Elenga
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Contributions

NE analysed the data and drafted the manuscript, VV, EM, EC, MP, PS and FM collected the data, provided necessary logistic support and have read the manuscript. NE and FM provided critical comments on the manuscript. I confirm that all authors read and approved the final manuscript.

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Correspondence to Narcisse Elenga.

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In memoriam of Thierry Basset.

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Elenga, N., Vantilcke, V., Martin, E. et al. Red blood cell exchange in children with sickle cell disease. Int J Hematol 115, 107–113 (2022). https://doi.org/10.1007/s12185-021-03221-8

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  • DOI: https://doi.org/10.1007/s12185-021-03221-8

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