JEROME I. BRODY, M.D., F.A.C.P.; MYRON H. GOLDSMITH, M.D.; S. KWAN PARK, M.D.; HENRY D. SOLTYS, M.D.
Eight patients with the symptomatic crises of sickle cell anemia were treated by limited exchange transfusion. Buffy coat-free, packed erythrocytes were used in therapy. On the first day 250 ml red cells were given followed by phlebotomy of 500 ml whole blood and an infusion of a second 250 ml of red cells. The second day's program resembled the first except that two 250-ml units of red cells succeeded the phlebotomy. The method is not accompanied by untoward reactions, it rapidly ameliorates fever and bone pain; interrupts the cycle of hypoxia, vasocclusion, and organ injury by diluting autologous circulating erythrocytes containing sickle hemoglobin with those holding hemoglobin A; and raises the oxygen-carrying capacity of the blood with only a minor increase in total blood volume. The average length of hospital stay has been reduced from 7 to 3 days. This program probably should supplant other types of treatment that do not directly influence the dynamic changes involved in the pathogenesis of symptomatic crises in sickle cell anemia.
BRODY JI, GOLDSMITH MH, PARK SK, SOLTYS HD. Symptomatic Crises of Sickle Cell Anemia Treated by Limited Exchange Transfusion. Ann Intern Med. ;72:327–330. doi: 10.7326/0003-4819-72-3-327
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Published: Ann Intern Med. 1970;72(3):327-330.
Hematology/Oncology, Red Cell Disorders.
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