Regular Transfusion Lowers Plasma Free Hemoglobin in Children with Sickle-cell Disease at Risk for Stroke.
From: Department of Neurology, School of Medicine, Medical College of Georgia, Augusta, GA 30912, USA.
Stroke; a journal of cerebral circulation
- Publish Date: Jun 2006
- ISSN: 1524-4628
- Volume: 37
- Issue: 6
- Pages: 1424-6
- Medium: Internet
- Language: English
- Citation (JAMA): Lezcano Nelson E, Odo Nadine, Kutlar Abdullah, et al. Regular Transfusion Lowers Plasma Free Hemoglobin in Children with Sickle-cell Disease at Risk for Stroke.. Stroke Jun 2006;37:1424-6
Abstract
BACKGROUND AND PURPOSE: Intravascular hemolysis releases large amounts of free hemoglobin (PFH) in plasma of sickle-cell disease (SCD) patients. PFH has been associated with harmful endothelial actions including scavenging nitric oxide (NO). Whether PFH plays a role in stroke in SCD has not been examined. METHODS: Serum levels of PFH, lactate dehydrogenase, and total bilirubin were measured in stored sera from children at risk for stroke treated in a randomized controlled trial of regular red cell transfusion (STOP study). Baseline and post-treatment (approximately 1 year of transfusion) were compared to determine whether treatment (which reduces stroke risk by 90%) was associated with reduction in markers of hemolysis. RESULTS: Baseline serum PFH values did not differ between treatment groups. PFH declined with repeated transfusion from 78.7+/-8.2 mg/dL to 34.4+/-3.4 mg/dL (P<0.001). With only episodic or no transfusion the drop was smaller: 80.9+/-7.5 to 62.8+/-5.0 (P=0.019). The decrease was larger in those with regular transfusion (56% versus 22%; P<0.001). Reduction of lactate dehydrogenase and total bilirubin was observed only in those on regular transfusion. CONCLUSIONS: Regular transfusion which lowers stroke risk is associated with a significant reduction in PFH. A role for PFH in promoting stroke in SCD should be investigated.
Mesh Headings (Keywords): Anemia, Sickle Cell, Bilirubin, Blood Transfusion, Child, Hemoglobins, Humans, L-Lactate Dehydrogenase, Risk Factors, Stroke
Check for Full Text / PubMed Unique Identifier (PMID): 16627796
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