Please select the option that best describes you:
Topics:
General Internal Medicine • Hematology • Sickle Cell • Benign Hematology • Neurology • Vascular Neurology
How long would you continue chronic transfusion therapy for adult sickle cell patients who have had a stroke?
Is treatment indefinite or do you consider discontinuing chronic transfusions at some threshold?
Answer from: at Academic Institution
There is no high-level evidence to inform the decision of how long to continue chronic transfusion in this scenario. Decisions on whether to continue indefinitely are affected by multiple factors like the presence of RBC alloimmunization, whether the patient was on hydroxyurea at MTD or not at the t...
Sign in or Register to read more
Answer from: at Academic Institution
Management of stroke in adults is not informed by the data that is available for children. Assuming that this was not a hemorrhagic stroke and that there was no moya-moya, I would continue transfusions indefinitely. To slow iron accumulation, I would use an exchange transfusion aiming for an HbS lev...