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Symptomatic Crises of Sickle Cell Anemia Treated by Limited Exchange Transfusion

JEROME I. BRODY, M.D., F.A.C.P.; MYRON H. GOLDSMITH, M.D.; S. KWAN PARK, M.D.; and HENRY D. SOLTYS, M.D.
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▸Requests for reprints should be addressed to Jerome I. Brody, M.D., Department of Medicine, Graduate Hospital, University of Pennsylvania, Philadelphia, Pa. 19146


Philadelphia, Pennsylvania


Ann Intern Med. 1970;72(3):327-330. doi:10.7326/0003-4819-72-3-327
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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.

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