Apheresis Medicine in the Management of Sickle Cell Disease

Despite advances in care, patients with sickle cell disease have significant morbidity and mortality. One challenge is the optimal use of simple vs exchange transfusion vs no transfusion when managing these patients. Simple transfusions lead to iron overload while exchange transfusions may expose patients to increase numbers of red blood cell units. The mechanism of benefit from transfusion (oxygen delivery vs marrow suppression) has not been defined. Further, there are compelling preliminary data suggesting that plasma exchange may be have benefit for patients in crisis, but neither the mechanism for this benefit nor the precise role of plasma exchange has been defined. Well-designed clinical trials are clearly needed