Transfusions Key for Sickle Cell Patients
Posted on: Tuesday, 3 January 2006, 09:00 CST
By Rebecca Vesely, STAFF WRITER
Some children with sickle cell disease need blood transfusions to prevent strokes and shouldn't halt the treatment despite side effects, according to a study released Thursday that included Children's Hospital and Research Center Oakland.
The study, published in the New England Journal of Medicine, dashed hopes that some children with sickle cell disease could discontinue blood transfusions under careful monitoring. The study was cut short when two children enrolled in the trial developed strokes after stopping monthly blood transfusions.
Regular transfusions have long been standard treatment for children with sickle cell anemia at risk for stroke. About one in 10 patients under age 20 with sickle cell anemia get strokes, though scientists are not sure exactly why. The transfusions can cut the risk of stroke by 90 percent.
In the late 1990s, researchers, led byDr. Robert Adams of the Medical College of Georgia, found that a sonogram test that detects the velocity of blood vessels could accurately estimate which children with sickle cell anemia were at risk of stroke.
Parents of children found to be at risk for strokes were advised to start monthly blood transfusions -- the only known preventive treatment.
In the new study, Adams and other researchers wanted to see whether children undergoing regular transfusions could stop the treatment -- provided they were monitored for stroke risk using the sonogram test.
Dr. Keith Quirolo, a sickle cell expert at Children's Hospital Oakland, where children were enrolled in the trial, said researches wondered if children would pass a point where they needed the procedure.
"We wanted to know, was there a critical time when you transfused kids, then stopped the transfusions and they wouldn't be at risk for stroke?" Quirolo said.
For children who are at risk for stroke and have sickle cell disease, transfusions can lead to a normal life.
Nikita Williams, 15, of Oakland has undergone monthly blood transfusions at Children's Hospital Oakland since age 11, when she suffered a mild stroke and was in intensive care with other complications for two months.
Her mother, Erica Cloud, said in a phone interview that the transfusions make her daughter feel energetic.
"The blood transfusions keep her out of crisis," Cloud said. "I say thanks to the blood transfusions. She wasn't doing well without them."
Researchers are looking at genetic factors that predispose children with sickle cell anemia to strokes, Quirolo said.
"The way they're going to cure stroke is to find out genetically what causes it," he said.
Contact Rebecca Vesely at rvesely@angnewspapers.com.
Source: Oakland Tribune
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