Prospects for primary stroke prevention in children with sickle cell anaemia.

Jordan LC, Casella JF, DeBaun MR
Br J Haematol. 2012 157 (1): 14-25

PMID: 22224940 · PMCID: PMC3400704 · DOI:10.1111/j.1365-2141.2011.09005.x

This review will focus on the strengths and limitations associated with the current standard of care for primary prevention of ischaemic strokes in children with sickle cell anaemia (SCA) - transcranial Doppler ultrasound (TCD) screening followed by regular blood transfusion therapy when TCD measurement is above a threshold defined by a randomized clinical trial (RCT). The theoretical basis for potential alternative strategies for primary prevention of neurological injury in SCA is also discussed. These strategies will include, but will not be limited to: immunizations to prevent bacterial infections, particularly in low income countries; management of elevated blood pressure; and targeted strategies to increase baseline haemoglobin levels with therapies such as hyroxycarbamide or potentially definitive haematopoietic stem cell transplant.

© 2012 Blackwell Publishing Ltd.

MeSH Terms (16)

Adolescent Anemia, Sickle Cell Antisickling Agents Bacterial Infections Blood Transfusion Brain Ischemia Child Child, Preschool Female Hematopoietic Stem Cell Transplantation Humans Hydroxyurea Immunization Male Stroke Transplantation, Homologous

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