Emily Riehm Meier1, Ross M Fasano2, Monica Estrada3, Jianping He4, Naomi L C Luban2, Robert McCarter5. 1. Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC; Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC. Electronic address: emeier@ihtc.org. 2. Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC; Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC. 3. Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC. 4. Division of Biostatistics and Study Methodology, Children's National Medical Center, Washington, DC. 5. Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC; Division of Biostatistics and Study Methodology, Children's National Medical Center, Washington, DC.
Abstract
OBJECTIVE: To improve prediction of sickle cell anemia severity at an early age, we evaluated whether absolute reticulocyte count (ARC) or hemoglobin (Hb) levels during early infancy (2-6 months of age) in patients with sickle cell anemia predict the risk of later developing an abnormal (abTCD) or conditional (cdTCD) Transcranial Doppler (TCD). STUDY DESIGN: We used chart review to identify 121 consecutive patients who underwent TCD screening and had steady state ARC and Hb levels recorded between 2 and 6 months of age. Cox regression analysis was used to determine the relationship between ARC, Hb levels, and risk of developing cdTCD/abTCD over time. RESULTS: Mean ARC in early infancy was highest and mean Hb lowest in those children with abTCDs and cdTCDs. Cox regression analysis revealed that those subjects with an ARC ≥200 K/μL in early infancy had nearly 3 times the risk of having an abTCD/cdTCD than the group with an ARC <200 K/μL, and patients with a Hb <8.5 g/dL had 2.7 times the risk of having an abTCD/cdTCD. CONCLUSIONS: These data suggest that both elevated ARC and low baseline Hb during early infancy are associated with an increased risk of developing a cdTCD or abTCD later in childhood.
OBJECTIVE: To improve prediction of sickle cell anemia severity at an early age, we evaluated whether absolute reticulocyte count (ARC) or hemoglobin (Hb) levels during early infancy (2-6 months of age) in patients with sickle cell anemia predict the risk of later developing an abnormal (abTCD) or conditional (cdTCD) Transcranial Doppler (TCD). STUDY DESIGN: We used chart review to identify 121 consecutive patients who underwent TCD screening and had steady state ARC and Hb levels recorded between 2 and 6 months of age. Cox regression analysis was used to determine the relationship between ARC, Hb levels, and risk of developing cdTCD/abTCD over time. RESULTS: Mean ARC in early infancy was highest and mean Hb lowest in those children with abTCDs and cdTCDs. Cox regression analysis revealed that those subjects with an ARC ≥200 K/μL in early infancy had nearly 3 times the risk of having an abTCD/cdTCD than the group with an ARC <200 K/μL, and patients with a Hb <8.5 g/dL had 2.7 times the risk of having an abTCD/cdTCD. CONCLUSIONS: These data suggest that both elevated ARC and low baseline Hb during early infancy are associated with an increased risk of developing a cdTCD or abTCD later in childhood.
Authors: Parul Rai; Vijaya M Joshi; Jason F Goldberg; Amber M Yates; Victoria I Okhomina; Rhiannon Penkert; Kenneth I Ataga; Guolian Kang; Jane S Hankins Journal: Blood Adv Date: 2021-01-12
Authors: Megha Kaushal; Colleen Byrnes; Zarir Khademian; Natalie Duncan; Naomi L C Luban; Jeffery L Miller; Ross M Fasano; Emily Riehm Meier Journal: PLoS One Date: 2016-04-26 Impact factor: 3.240
Authors: André Rolim Belisário; Paula F Blatyta; Diana Vivanco; Claudia Di Lorenzo Oliveira; Anna Bárbara Carneiro-Proietti; Ester Cerdeira Sabino; Cesar de Almeida-Neto; Paula Loureiro; Cláudia Máximo; Sheila de Oliveira Garcia Mateos; Miriam V Flor-Park; Daniela de Oliveira Werneck Rodrigues; Rosimere Afonso Mota; Thelma T Gonçalez; Thomas J Hoffmann; Shannon Kelly; Brian Custer Journal: BMC Infect Dis Date: 2020-08-27 Impact factor: 3.090