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Ribeil J, Labopin M, Stanislas A, Deloison B, Lemercier D, Habibi A, Albinni S, Charlier C, Lortholary O, Lefrere F, De Montalembert M, Blanche S, Galactéros F, Tréluyer J, Gluckman E, Ville Y, Joseph L, Delville M, Benachi A, Cavazzana M. Transfusion-related adverse events are decreased in pregnant women with sickle cell disease by a change in policy from systematic transfusion to prophylactic oxygen therapy at home: A retrospective survey by the international sickle cell disease observatory. Am J Hematol 2018; 93:794-802. [PMID: 29603363 PMCID: PMC6001537 DOI: 10.1002/ajh.25097] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 03/21/2018] [Accepted: 03/22/2018] [Indexed: 02/02/2023]
Abstract
Sickle cell disease (SCD) in pregnancy can be associated with adverse maternal and perinatal outcomes. Furthermore, complications of SCD can be aggravated by pregnancy. Optimal prenatal care aims to decrease the occurrence of maternal and fetal complications. A retrospective, French, two-center study compared two care strategies for pregnant women with SCD over two time periods. In the first study period (2005-2010), the women were systematically offered prophylactic transfusions. In the second study period (2011-2014), a targeted transfusion strategy was applied whenever possible, and home-based prophylactic nocturnal oxygen therapy was offered to all the pregnant women. The two periods did not differ significantly in terms of the incidence of vaso-occlusive events. Maternal mortality, perinatal mortality, and obstetric complication rates were also similar in the two periods, as was the incidence of post-transfusion complications (6.1% in 2005-2010 and 1.3% in 2011-2014, P = .15), although no de novo alloimmunizations or delayed hemolysis transfusion reactions were observed in the second period. The results of this preliminary, retrospective study indicate that targeted transfusion plus home-based prophylactic nocturnal oxygen therapy is safe and may decrease transfusion requirements and transfusion-associated complications.
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Affiliation(s)
- Jean‐Antoine Ribeil
- Biotherapy DepartmentNecker Children's Hospital, Assistance Publique‐Hôpitaux de ParisParisFrance
- Biotherapy CIC, West University Hospital Group, Assistance Publique‐Hôpitaux de Paris, INSERMParisFrance
| | - Myriam Labopin
- Clinical Hematology and Cellular Therapy DepartmentSaint‐Antoine Hospital, Assistance Publique‐Hôpitaux de Paris, France ‐ INSERM UMRs 938, Pierre et Marie Curie University (UPMC, Paris VI)ParisFrance
| | - Aurélie Stanislas
- Biotherapy DepartmentNecker Children's Hospital, Assistance Publique‐Hôpitaux de ParisParisFrance
- Biotherapy CIC, West University Hospital Group, Assistance Publique‐Hôpitaux de Paris, INSERMParisFrance
| | - Benjamin Deloison
- Department of Obstetrics and Fetal MedicineNecker Children's Hospital, Assistance Publique‐Hôpitaux de ParisParisFrance
| | - Delphine Lemercier
- Department of Obstetrics and Fetal MedicineNecker Children's Hospital, Assistance Publique‐Hôpitaux de ParisParisFrance
| | - Anoosha Habibi
- Reference Center for Sickle Cell Disease, Henri Mondor Hospital, Assistance Publique‐Hôpitaux de ParisCréteilFrance
| | - Souha Albinni
- Necker Children's HospitalFrench Blood Establishment ‐ Ile de FranceParisFrance
| | - Caroline Charlier
- Necker Children's Hospital, Assistance Publique‐Hôpitaux de ParisNecker Pasteur Center for Infectious Diseases and Tropical MedicineParisFrance
| | - Olivier Lortholary
- Imagine InstituteParisFrance
- Necker Children's Hospital, Assistance Publique‐Hôpitaux de ParisNecker Pasteur Center for Infectious Diseases and Tropical MedicineParisFrance
- Paris Descartes UniversityParisFrance
| | - François Lefrere
- Biotherapy DepartmentNecker Children's Hospital, Assistance Publique‐Hôpitaux de ParisParisFrance
- Biotherapy CIC, West University Hospital Group, Assistance Publique‐Hôpitaux de Paris, INSERMParisFrance
| | - Mariane De Montalembert
- Reference Centre for Sickle Cell Disease, Pediatric DepartmentNecker Children's Hospital, Assistance Publique‐Hôpitaux de ParisParisFrance
| | - Stéphane Blanche
- Unit of Pediatric Immunology and HematologyNecker Children's Hospital, Assistance Publique‐Hôpitaux de ParisParisFrance
| | - Frédéric Galactéros
- Reference Center for Sickle Cell Disease, Henri Mondor Hospital, Assistance Publique‐Hôpitaux de ParisCréteilFrance
| | - Jean‐Marc Tréluyer
- Paris Descartes UniversityParisFrance
- Necker Children's Hospital, Assistance Publique‐Hôpitaux de ParisClinical Research Unit/Clinical Investigation CentreParisFrance
| | - Eliane Gluckman
- Saint‐Louis Hospital, Paris, France and Monaco Scientific CenterEurocord Monacord International Observatory on Sickle Cell DiseaseMonaco
| | - Yves Ville
- Department of Obstetrics and Fetal MedicineNecker Children's Hospital, Assistance Publique‐Hôpitaux de ParisParisFrance
| | - Laure Joseph
- Biotherapy DepartmentNecker Children's Hospital, Assistance Publique‐Hôpitaux de ParisParisFrance
| | - Marianne Delville
- Biotherapy DepartmentNecker Children's Hospital, Assistance Publique‐Hôpitaux de ParisParisFrance
| | - Alexandra Benachi
- Department of Obstetrics and Gynecology and Reproductive MedicineAntoine Béclère Hospital, Assistance Publique‐Hôpitaux de Paris, Université Paris SudClamartFrance
| | - Marina Cavazzana
- Biotherapy DepartmentNecker Children's Hospital, Assistance Publique‐Hôpitaux de ParisParisFrance
- Biotherapy CIC, West University Hospital Group, Assistance Publique‐Hôpitaux de Paris, INSERMParisFrance
- Paris Descartes UniversityParisFrance
- Unit of Pediatric Immunology and HematologyNecker Children's Hospital, Assistance Publique‐Hôpitaux de ParisParisFrance
- Saint‐Louis Hospital, Paris, France and Monaco Scientific CenterEurocord Monacord International Observatory on Sickle Cell DiseaseMonaco
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