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Blood transfusion lowers risk of silent strokes in children with sickle cell anemia

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Sickle cell anemia, a disorder characterized by the body producing crescent-like shaped red blood cells that tend to block blood flow resulting in pain, organ damage and increased susceptibility to infection, affects about 90,000 to 100,000 individuals in the U.S and for every three children who have the disease, one experiences silent strokes which are marked by loss of blood flow to some parts of the brain.

Although the strokes do not immediately exhibit symptoms, they tend to recur and the damage can negatively affect a child's IQ. Findings of a new study, however, suggest a measure that could lower the odds of stroke from recurring in children with sickle cell anemia.

For the new study which was published in the New England Journal of Medicine on Aug. 21, James Casella, from Johns Hopkins Children's Center in Baltimore, and colleagues involved 196 patients with sickle cell anemia who were 5 and 10 years old and already experienced strokes. Of these patients, 99 were given blood transfusion every month for three years.

The researchers found that the children who were given blood transfusions had significantly lower risks of suffering from additional strokes compared with their counterparts who received the usual care. Over the course of the study, only six percent of the children who were given monthly blood transfusion had another silent stroke with one experiencing full blown stroke while the incidence occurred in 14 percent of the children in the control group.

Casella and colleagues noted that giving children suffering from sickle cell anemia who already had strokes a monthly blood transfusion could reduce their likelihood to have another stroke by 58 percent.

"Regular blood-transfusion therapy significantly reduced the incidence of the recurrence of cerebral infarct in children with sickle cell anemia," the researchers concluded.

Study co-author Allison King, from Washington University School of Medicine's Department of Pediatrics, said the transfusions may be helping the patients as these raise the amount of blood that circulate in their body and reduce the percentage of sickle cells in the bloodstream. The researcher said that keeping the number of sickled cells to less than 30 percent appears to be ideal and although transfusion comes with risks, King said that the risks of infection is quite low.

"We're getting very good at screening our blood supply," King said. "The risk of an allergic reaction can be reduced through better matching of compatibility factors and blood drives to increase the resources available for transfusion."

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