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Bathla T, Lotfollahzadeh S, Quisel M, Mehta M, Malikova M, Chitalia VC. End Organ Affection in Sickle Cell Disease. Cells 2024; 13:934. [PMID: 38891066 PMCID: PMC11174153 DOI: 10.3390/cells13110934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/21/2024] [Accepted: 05/24/2024] [Indexed: 06/20/2024] Open
Abstract
Sickle cell disease is an orphan disease affecting ethnic minorities and characterized by profound systemic manifestations. Although around 100,000 individuals with SCD are living in the US, the exact number of individuals is unknown, and it is considered an orphan disease. This single-gene disorder leads to red blood cell sickling and the deoxygenation of hemoglobin, resulting in hemolysis. SCD is associated with acute complications such as vaso-occlusive crisis, infections, and chronic target organ complications such as pulmonary disease and renal failure. While genetic therapy holds promise to alter the fundamental disease process, the major challenge in the field remains the target end organ damage and ways to mitigate or reverse it. Here, we provide an overview of the clinical manifestations and pathogenesis with a focus on end-organ damage and current therapeutic options, including recent FDA-approved stem cell and gene editing therapies.
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Affiliation(s)
- Tanvi Bathla
- Renal Section, Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA; (T.B.); (S.L.); (M.Q.)
| | - Saran Lotfollahzadeh
- Renal Section, Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA; (T.B.); (S.L.); (M.Q.)
| | - Matthew Quisel
- Renal Section, Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA; (T.B.); (S.L.); (M.Q.)
| | - Mansi Mehta
- Saint Vincent’s Medical Hospital, Worcester, MA 01608, USA;
| | - Marina Malikova
- Department of Surgery, Boston University School of Medicine, Boston, MA 02118, USA;
| | - Vipul C. Chitalia
- Renal Section, Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA; (T.B.); (S.L.); (M.Q.)
- Veterans Affairs Boston Healthcare System, Boston, MA 02118, USA
- Institute of Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Center of Cross-Organ Vascular Pathology, Department of Medicine, Boston University Medical Center, Evans Biomedical Research Center, X-530, Boston, MA 02118, USA
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2
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Casale M, Di Girolamo MG, Di Maio N, Tomeo R, Iengo M, Scianguetta S, Palma T, Porcelli F, Misso S, Perrotta S. Absence of blood donors' anti-SARS-CoV-2 antibodies in pre-storage leukoreduced red blood cell units indicates no role of passive immunity for blood recipients. Ann Hematol 2024; 103:623-629. [PMID: 37758964 PMCID: PMC10799091 DOI: 10.1007/s00277-023-05473-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 09/20/2023] [Indexed: 09/29/2023]
Abstract
Transfer of vaccine antibodies (Ab) from donors to recipients after transfusion of packed red blood cells (RBC) is supposed, thus affecting the recipients' response to vaccinations. In this prospective study, SARS-CoV-2 IgG level in donors' serum and RBC supernatant samples was assessed. Among 346 subjects, 280 were referred for hyperimmune plasma donation and 30 for whole blood donations. All units underwent pre-storage filtration, and residual plasma volume was 18±18 mL. The mean total IgG and IgM levels were 171.43 ± 48.79 and 11.43 ± 10.69 mg/dL respectively, with significant reduction after plasma depletion and filtration (IgG 5.86 ± 5.2 and IgM 1.43 ± 3.78, p < 0.05). Anti-COVID-19 Ab were identified in serum of 28/30 (93.5%) blood donors but were absent in all blood units. The mean value of anti-SARS-CoV-2 IgG level in donors' serum samples and in RBC units was 8.80 S/C (range 0.01-23.4) and 0.11 (range 0.01-0.37) S/C, respectively (p<0.05). This study shows deplasmation and leukodepletion of RBC units ensured removal of IgG content and no red blood cell unit was reactive for anti-COVID-19 antibodies even from donors with high serum titre. These findings demonstrate that deplasmated and leukodepleted RBCs are not to be considered blood products containing substantial amounts of immune globulin, and differently from other blood derived-products containing Ab, transfusions with deplasmated and leukodepleted RBCs do not require delayed vaccinations and a revision of current recommendations is requested.
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Affiliation(s)
- Maddalena Casale
- Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy.
| | | | - Nicoletta Di Maio
- Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Rita Tomeo
- Medicina Trasfusionale, ASL Caserta, Caserta, Italy
| | | | | | - Teresa Palma
- Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Federica Porcelli
- Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | | | - Silverio Perrotta
- Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
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3
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Pinto VM, De Franceschi L, Gianesin B, Gigante A, Graziadei G, Lombardini L, Palazzi G, Quota A, Russo R, Sainati L, Venturelli D, Forni GL, Origa R. Management of the Sickle Cell Trait: An Opinion by Expert Panel Members. J Clin Med 2023; 12:jcm12103441. [PMID: 37240547 DOI: 10.3390/jcm12103441] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/21/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
The number of individuals with the sickle cell trait exceeds 300 million worldwide, making sickle cell disease one of the most common monogenetic diseases globally. Because of the high frequency of sickle cell disease, reproductive counseling is of crucial importance. In addition, unlike other carrier states, Sickle Cell Trait (SCT) seems to be a risk factor for several clinical complications, such as extreme exertional injury, chronic kidney disease, and complications during pregnancy and surgery. This expert panel believes that increasing knowledge about these clinical manifestations and their prevention and management can be a useful tool for all healthcare providers involved in this issue.
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Affiliation(s)
- Valeria Maria Pinto
- Centro della Microcitemia, Anemie Congenite e Dismetabolismo del Ferro, E.O. Ospedali Galliera, 16128 Genova, Italy
| | | | - Barbara Gianesin
- Centro della Microcitemia, Anemie Congenite e Dismetabolismo del Ferro, E.O. Ospedali Galliera, 16128 Genova, Italy
- ForAnemia Foundation, 16124 Genova, Italy
| | - Antonia Gigante
- ForAnemia Foundation, 16124 Genova, Italy
- Società Italiana Talassemie ed Emoglobinopatie (SITE), 09100 Cagliari, Italy
| | - Giovanna Graziadei
- Centro Malattie Rare Internistiche, Medicina Generale, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy
| | - Letizia Lombardini
- Centro Nazionale Trapianti, Istituto Superiore di Sanità, 00161 Roma, Italy
| | - Giovanni Palazzi
- U.O. Oncoematologia Pediatrica, Azienda Ospedaliero-Universitaria di Modena, 41125 Modena, Italy
| | | | - Rodolfo Russo
- Clinica Nefrologica, Dialisi e Trapianto, Dipartimento di Medicina Integrata con il Territorio, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Laura Sainati
- Oncoematologia Pediatrica, Azienda Ospedaliera-Università di Padova, 35128 Padova, Italy
| | - Donatella Venturelli
- Servizio Immunotrasfusionale, Azienda Ospedaliero-Universitaria di Modena, 41125 Modena, Italy
| | - Gian Luca Forni
- Centro della Microcitemia, Anemie Congenite e Dismetabolismo del Ferro, E.O. Ospedali Galliera, 16128 Genova, Italy
| | - Raffaella Origa
- Talassemia, Ospedale Pediatrico Microcitemico 'A.Cao', ASL8, Università di Cagliari, 09121 Cagliari, Italy
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Real-World Evidence on Disease Burden and Economic Impact of Sickle Cell Disease in Italy. J Clin Med 2022; 12:jcm12010117. [PMID: 36614918 PMCID: PMC9821386 DOI: 10.3390/jcm12010117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/05/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
A real-world analysis was conducted in Italy among sickle cell disease (SCD) patients to evaluate the epidemiology of SCD, describe patients' characteristics and the therapeutic and economic burden. A retrospective analysis of administrative databases of various Italian entities was carried out. All patients with ≥1 hospitalization with SCD diagnosis were included from 01/2010-12/2017 (up to 12/2018 for epidemiologic analysis). The index date corresponded to the first SCD diagnosis. In 2018, SCD incidence rate was 0.93/100,000, the prevalence was estimated at 13.1/100,000. Overall, 1816 patients were included. During the 1st year of follow-up, 50.7% of patients had one all-cause hospitalization, 27.8% had 2, 10.4% had 3, and 11.1% had ≥4. Over follow-up, 6.1-7.2% of patients were treated with SCD-specific, 58.4-69.4% with SCD-related, 60.7-71.3% with SCD-complications-related drugs. Mean annual number per patient of overall treatments was 14.9 ± 13.9, hospitalizations 1.1 ± 1.1, and out-patient services 5.3 ± 7.6. The total mean direct cost per patient was EUR 7918/year (EUR 2201 drugs, EUR 3320 hospitalizations, and EUR 2397 out-patient services). The results from this real-world analysis showed a high disease burden for SCD patients with multiple hospitalizations during the follow-up. High healthcare resource utilization and costs were associated with patient' management and were most likely underestimated since indirect costs and Emergency Room admissions were not included.
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Guerzoni ME, Marchesi S, Palazzi G, Lodi M, Pinelli M, Venturelli D, Bigi E, Quaglia N, Corti P, Serra R, Colombatti R, Sainati L, Masera N, Colombo F, Barone A, Iughetti L. Environmental Factors in Northern Italy and Sickle Cell Disease Acute Complications: A Multicentric Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1478. [PMID: 36291415 PMCID: PMC9600492 DOI: 10.3390/children9101478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/13/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Environmental factors seem to influence clinical manifestations of sickle cell disease (SCD), but few studies have shown consistent findings. We conducted a retrospective multicentric observational study to investigate the influence of environmental parameters on hospitalization for vaso-occlusive crises (VOC) or acute chest syndrome (ACS) in children with SCD. METHODS Hospital admissions were correlated with daily meteorological and air-quality data obtained from Environmental Regional Agencies in the period 2011-2015. The effect of different parameters was assessed on the day preceding the crisis up to ten days before. Statistical analysis was performed using a quasi-likelihood Poisson regression in a generalized linear model. RESULTS The risk of hospitalization was increased for low maximum temperature, low minimum relative humidity, and low atmospheric pressure and weakly for mean wind speed. The diurnal temperature range and temperature difference between two consecutive days were determined to be important causes of hospitalization. For air quality parameters, we found a correlation only for high levels of ozone and for low values at the tail corresponding to the lowest concentration of this pollutant. CONCLUSIONS Temperature, atmospheric pressure, humidity and ozone levels influence acute complications of SCD. Patients' education and the knowledge of the modes of actions of these factors could reduce hospitalizations.
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Affiliation(s)
- Maria Elena Guerzoni
- Pediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Stefano Marchesi
- Arpae-Agenzia Regionale per la Prevenzione, L’ambiente e L’energia dell’Emilia, Romagna, 41121 Modena, Italy
| | - Giovanni Palazzi
- Oncology and Hematology Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Mariachiara Lodi
- Department of Medical and Surgical Sciences for Mothers, Child and Adults, Post Graduate School of Pediatrics, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Margherita Pinelli
- Pediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Donatella Venturelli
- Department of Transfusion Medicine, University Hospital of Modena, 41124 Modena, Italy
| | - Elena Bigi
- Pediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Nadia Quaglia
- Clinic of Pediatric Hematology Oncology, Department of Woman’s and Child’s Health, University Hospital of Padova, 35128 Padova, Italy
| | - Paola Corti
- Department of Pediatrics, University of Milano Bicocca, Fondazione MBBM, 20900 Monza, Italy
| | - Roberta Serra
- Pediatric Onco-Hematology, Department of Pediatrics, University Hospital of Parma, 43126 Parma, Italy
| | - Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Woman’s and Child’s Health, University Hospital of Padova, 35128 Padova, Italy
| | - Laura Sainati
- Clinic of Pediatric Hematology Oncology, Department of Woman’s and Child’s Health, University Hospital of Padova, 35128 Padova, Italy
| | - Nicoletta Masera
- Department of Pediatrics, University of Milano Bicocca, Fondazione MBBM, 20900 Monza, Italy
| | - Francesca Colombo
- Department of Pediatrics, University of Milano Bicocca, Fondazione MBBM, 20900 Monza, Italy
| | - Angelica Barone
- Pediatric Onco-Hematology, Department of Pediatrics, University Hospital of Parma, 43126 Parma, Italy
| | - Lorenzo Iughetti
- Pediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41121 Modena, Italy
- Oncology and Hematology Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, 41121 Modena, Italy
- Department of Medical and Surgical Sciences for Mothers, Child and Adults, Post Graduate School of Pediatrics, University of Modena and Reggio Emilia, 41121 Modena, Italy
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Alwaheed AJ, Alqatari SG, AlKhafaji DM, Al Argan RJ, Al Sultan OA, AlSulaiman RS, AlShahrani FS, Alghamdi FA, Alkhudair AM, Alghamdi AA. Clinical outcome of pre-operative blood transfusion for sickle cell disease patients in post-operative complications. Hosp Pract (1995) 2022; 50:361-367. [PMID: 36062975 DOI: 10.1080/21548331.2022.2121574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND Preoperative blood transfusion for patients with sickle cell disease is a debatable topic and it can be lifesaving. Sickle cell disease patients are at high risk for vaso-occlusive crisis due to the large concentration of sickle hemoglobin (HgbS) in their blood. Despite the current extensive research into this disease, there is still no consensus over whether blood transfusion is a preferable preoperative modality among patients undergoing elective surgical procedures. METHOD A retrospective observational study, which enrolled 204 patients with Sickle cell disease who underwent surgery at King Fahad Hospital of the University (KFHU) over the last five years. The primary objective was to determine whether there is evidence that preoperative blood transfusion for SCD patients undergoing surgical procedures will reduce postoperative complications related to SCD. RESULTS A total of 204 patients were included, of which 30% had preoperative blood transfusion. Majority of patient 44% had undergone cholecystectomy. On multivariate logistic regression analysis, patients who did not undergo blood transfusion had significantly higher risk to develop post-operative SCD complications (OR=3.07, P value= 0.002). In addition, they had significantly prolonged hospitalization (OR= 2.22, P value= 0.08). In contrast, patients who received blood transfusion had lower risk for developing post-operative SCD related complications (OR=1.87, P value= 0.29), and decrease in the duration of hospitalization by (OR=0.49, P value= 0.045). CONCLUSION Our study showed that patients who had not undergo preoperative blood transfusion had higher risk to develop postoperative complications and prolonged hospital stay compared to those who underwent blood transfusion.
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Affiliation(s)
- Abrar J Alwaheed
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Safi G Alqatari
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Dania M AlKhafaji
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Reem J Al Argan
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Osama A Al Sultan
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Reem S AlSulaiman
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Faisal S AlShahrani
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Faisal A Alghamdi
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Abdullah M Alkhudair
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Abdulrahman A Alghamdi
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
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Aramayo-Singelmann C, Halimeh S, Proske P, Vignalingarajah A, Cario H, Christensen MO, Yamamoto R, Röth A, Reinhardt D, Reinhardt HC, Alashkar F. Screening and diagnosis of hemoglobinopathies in Germany: Current state and future perspectives. Sci Rep 2022; 12:9762. [PMID: 35697769 PMCID: PMC9192588 DOI: 10.1038/s41598-022-13751-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/12/2022] [Indexed: 11/21/2022] Open
Abstract
This monocentric study conducted at the Pediatric and Adult Hemoglobinopathy Outpatient Units of the University Hospital of Essen summarizes the results of hemoglobinopathies diagnosed between August 2018 and September 2021, prior to the introduction of a general newborn screening (NBS) for SCD in Germany (October 2021). In total, 339 patients (pts.), 182 pediatric [50.5% males (92/182)] and 157 adult pts. [75.8% females (119/157)] were diagnosed by molecular analysis. The most common (parental) descent among affected pts. were the Middle Eastern and North African/Turkey (Turkey: 19.8%, Syria: 11.8%, and Iraq: 5.9%), and the sub-Saharan African region (21.3%). Median age at diagnosis in pediatric carriers [N = 157; 54.1% males (85/157)] was 6.2 yrs. (range 1 (months) mos.–17.8 yrs.) and 31 yrs. (range 18–65 yrs.) in adults [N = 53; 75.2% females (115/153)]. Median age at diagnosis of homozygous or compound-heterozygous disease in pediatric pts. (72% (18/25) females) was 3.7 yrs., range 4 mos.–17 yrs. (HbSS (N = 13): 2.5 yrs., range 5 mos.–7.8 yrs.; HbS/C disease (N = 5): 8 yrs., range 1–8 yrs.; homozygous/compound heterozygous β-thalassemia (N = 5): 8 yrs., range 3–13 yrs.), in contrast to HbH disease (N = 5): 18 yrs. (median), range 12–40 yrs. Hemoglobinopathies represent a relevant health problem in Germany due to immigration and late diagnosis of second/third generation migrants. SCD-NBS will accelerate diagnosis and might result in reduction of disease-associated morbidity. However, diagnosis of carriers and/or disease-states (i.e. thalassemic syndromes) in newly immigrated and undiagnosed patients will further be delayed. A first major step has been taken, but further steps are required.
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Affiliation(s)
- Carmen Aramayo-Singelmann
- Department of Pediatrics III, University Children's Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Susan Halimeh
- Department of Pediatrics III, University Children's Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Coagulation Center Rhein-Ruhr, Duisburg, Germany
| | - Pia Proske
- Department of Hematology and Stem Cell Transplantation, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Abinuja Vignalingarajah
- Department of Pediatrics III, University Children's Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Holger Cario
- Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | | | | | - Alexander Röth
- Department of Hematology and Stem Cell Transplantation, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Dirk Reinhardt
- Department of Pediatrics III, University Children's Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Hans Christian Reinhardt
- Department of Hematology and Stem Cell Transplantation, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ferras Alashkar
- Department of Hematology and Stem Cell Transplantation, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
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Laezza N, Gião N, Borges C, Knoblich M. Rare paediatric case of agenesis of the vermiform appendix, ileal duplication and sickle cell disease. BMJ Case Rep 2022; 15:e248181. [PMID: 35580950 PMCID: PMC9114869 DOI: 10.1136/bcr-2021-248181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2022] [Indexed: 11/04/2022] Open
Abstract
This study reports an exceptional case of a 14-year-old girl with sickle cell disease that was diagnosed with agenesis of the vermiform appendix and ileal duplication. Both consist of extremely rare gastrointestinal malformations whose association has never been described. The preadolescent girl presented with abdominal pain and vomiting, and the ultrasound was suggestive of acute appendicitis. Surgical findings were agenesis of the vermiform appendix and a T-shaped ileal malformation with inflammatory changes. The patient underwent resection and ileal end-to-end anastomosis. Histopathological evaluation identified an ileal duplication, with small bowel and colonic mucosa, no communication to the adjacent ileum and ischaemic changes. At 8-month follow-up, the patient was asymptomatic.
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Affiliation(s)
- Nadia Laezza
- Department of Pediatric Surgery, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Nuno Gião
- Pathological Anatomy Department, Hospital de São José, Centro Hospitalar de Lisboa Central EPE, Lisboa, Portugal
| | - Cristina Borges
- Department of Pediatric Surgery, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central EPE, Lisboa, Portugal
| | - Maria Knoblich
- Department of Pediatric Surgery, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central EPE, Lisboa, Portugal
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9
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Casale M, Baldini MI, Del Monte P, Gigante A, Grandone A, Origa R, Poggi M, Gadda F, Lai R, Marchetti M, Forni GL. Good Clinical Practice of the Italian Society of Thalassemia and Haemoglobinopathies (SITE) for the Management of Endocrine Complications in Patients with Haemoglobinopathies. J Clin Med 2022; 11:jcm11071826. [PMID: 35407442 PMCID: PMC8999784 DOI: 10.3390/jcm11071826] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 02/01/2023] Open
Abstract
Background: The treatment of endocrinopathies in haemoglobinopathies is a continually expanding research area; therefore, recommendations supporting the appropriateness of treatments are a pressing need for the medical community. Methods: The Management Committee of SITE selected and gathered a multidisciplinary and multi-professional team, including experts in haemoglobinopathies and experts in endocrinopathies, who have been flanked by experts with methodological and organizational expertise, in order to formulate recommendations based on the available scientific evidence integrated by personal clinical experience. The project followed the systematic approach for the production of clinical practice guidelines according to the methodology suggested by the National Center for Clinical Excellence, Quality and Safety of Care (CNEC). Results: Out of 14 topics, 100 clinical questions were addressed, and 206 recommendations were elaborated on. The strength of recommendations, panel agreement, a short general description of the topic, and the interpretation of evidence were reported. Conclusions: Good Practice Recommendations are the final outcome of translational research and allow one to transfer to the daily clinical practice of endocrine complications in haemoglobinopathies.
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Affiliation(s)
- Maddalena Casale
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy;
- Correspondence: ; Tel.: +39-081-566-5432
| | - Marina Itala Baldini
- Centro Malattie Rare, UOC Medicina Interna, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.I.B.); (F.G.)
| | | | - Antonia Gigante
- Società Italiana Talassemie d Emoglobinopatie (SITE), Fondazione per la Ricerca sulle Anemie ed Emoglobinopatie in Italia—For Anemia, 16124 Genoa, Italy;
| | - Anna Grandone
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Raffaella Origa
- SSD Talassemia, Ospedale Pediatrico Microcitemico Cao, Università di Cagliari, 09124 Cagliari, Italy; (R.O.); (R.L.)
| | - Maurizio Poggi
- UOC Endocrinologia, Azienda Ospedaliera Sant’Andrea, 00189 Rome, Italy;
| | - Franco Gadda
- Centro Malattie Rare, UOC Medicina Interna, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.I.B.); (F.G.)
| | - Rosalba Lai
- SSD Talassemia, Ospedale Pediatrico Microcitemico Cao, Università di Cagliari, 09124 Cagliari, Italy; (R.O.); (R.L.)
| | - Monia Marchetti
- Day Service Ematologia, SOC Oncologia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| | - Gian Luca Forni
- Centro Emoglobinopatie e Anemie Congenite, Ospedali Galliera, 16128 Genoa, Italy;
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Graziadei G, De Franceschi L, Sainati L, Venturelli D, Masera N, Bonomo P, Vassanelli A, Casale M, Lodi G, Voi V, Rigano P, Pinto VM, Quota A, Notarangelo LD, Russo G, Allò M, Rosso R, D'Ascola D, Facchini E, Macchi S, Arcioni F, Bonetti F, Rossi E, Sau A, Campisi S, Colarusso G, Giona F, Lisi R, Giordano P, Boscarol G, Filosa A, Marktel S, Maroni P, Murgia M, Origa R, Longo F, Bortolotti M, Colombatti R, Di Maggio R, Mariani R, Piperno A, Corti P, Fidone C, Palazzi G, Badalamenti L, Gianesin B, Piel FB, Forni GL. Transfusional Approach in Multi-Ethnic Sickle Cell Patients: Real-World Practice Data From a Multicenter Survey in Italy. Front Med (Lausanne) 2022; 9:832154. [PMID: 35372393 PMCID: PMC8967327 DOI: 10.3389/fmed.2022.832154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/14/2022] [Indexed: 11/30/2022] Open
Abstract
Sickle cell disease (SCD) is a worldwide distributed hereditary red cell disorder characterized by recurrent acute vaso-occlusive crises (VOCs and anemia). Gold standard treatments are hydroxycarbamide (HC) and/or different red blood cell (RBC) transfusion regimens to limit disease progression. Here, we report a retrospective study on 1,579 SCD patients (median age 23 years; 802 males/777 females), referring to 34 comprehensive Italian centers for hemoglobinopathies. Although we observed a similar proportion of Caucasian (47.9%) and African (48.7%) patients, Italian SCD patients clustered into two distinct overall groups: children of African descent and adults of Caucasian descent. We found a subset of SCD patients requiring more intensive therapy with a combination of HC plus chronic transfusion regimen, due to partial failure of HC treatment alone in preventing or reducing sickle cell-related acute manifestations. Notably, we observed a higher use of acute transfusion approaches for SCD patients of African descent when compared to Caucasian subjects. This might be related to (i) age of starting HC treatment; (ii) patients' low social status; (iii) patients' limited access to family practitioners; or (iv) discrimination. In our cohort, alloimmunization was documented in 135 patients (8.5%) and was more common in Caucasians (10.3%) than in Africans (6.6%). Alloimmunization was similar in male and female and more frequent in adults than in children. Our study reinforces the importance of donor-recipient exact matching for ABO, Rhesus, and Kell antigen systems for RBC compatibility as a winning strategy to avoid or limit alloimmunization events that negatively impact the clinical management of SCD-related severe complications.
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Affiliation(s)
- Giovanna Graziadei
- Rare Diseases Center, General Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Laura Sainati
- Dipartimento della Salute della Donna e del Bambino Azienda Ospedaliera, Azienda Ospedaliera Universitaria, Padova, Italy
| | - Donatella Venturelli
- Servizio Immunotrasfusionale, Azienda Ospedaliero Universitaria Modena, Modena, Italy
| | - Nicoletta Masera
- Pediatric Clinic Hemato-Oncology Department, University of Milano-Bicocca, MBBM Foundation, San Gerardo Hospital, Monza, Italy
| | - Piero Bonomo
- Servizio Immunotrasfusionale, Azienda Ospedaliera Maria Paternò Arezzo, Ragusa, Italy
| | - Aurora Vassanelli
- UOC Medicina Trasfusionale, Azienda Ospedaliera Universitaria, Verona, Italy
| | - Maddalena Casale
- Department of Women, Child and General and Specialized Surgery, University “Luigi Vanvitelli”, Naples, Italy
| | - Gianluca Lodi
- Medicina Trasfusionale, Azienda Ospedaliera Universitaria Sant'Anna, Ferrara, Italy
| | - Vincenzo Voi
- Centro per le Emoglobinopatie – Dipartimento di Scienze Cliniche e Biologiche, Università di Torino, Ospedale San Luigi Gonzaga, Torino, Italy
| | - Paolo Rigano
- Campus of Haematology Franco e Piera Cutino, A.O.O.R. “Villa Sofia-Cervello” di Palermo, Palermo, Italy
| | - Valeria Maria Pinto
- Hematology, Thalassemia and Congenital Anemia Center, Ospedale Galliera, Genova, Italy
| | - Alessandra Quota
- Unità Operativa Semplice Dipartimentale Talassemia P.O. Vittorio Emanuele, Gela, Italy
| | - Lucia D. Notarangelo
- Italian Association of Pediatric Hematology Oncology (AIEOP) Coagulation Disorders Working Group, Brescia, Italy
| | - Giovanna Russo
- Pediatric Hematology/Oncology Unit, Università di Catania, Catania, Italy
| | - Massimo Allò
- Servizio Microcitemia, Presidio Ospedaliero SL 5, Crotone, Italy
| | - Rosamaria Rosso
- UOSD di Talassemia ed Emoglobinopatie, Azienda Ospedaliero-Universitaria Policlinico San Marco, Catania, Italy
| | - Domenico D'Ascola
- Centro Microcitemie, Azienda Ospedaliera “Bianchi-Melacrino-Morelli”, Reggio Calabria, Italy
| | - Elena Facchini
- SSD Oncoematologia Pediatrica - Policlinico di S.Orsola, Bologna, Italy
| | - Silvia Macchi
- Servizio Trasfusionale, Ospedale Santa Maria delle Croci, Ravenna, Italy
| | | | | | - Enza Rossi
- Unità Operativa Ematologia, Centro di Microcitemia, Azienda Ospedaliera di Cosenza, Presidio Ospedaliero “Annunziata” Cosenza, Cosenza, Italy
| | | | - Saveria Campisi
- Department of Talassemia, Siracusa Hospital, Siracusa, Italy
| | | | - Fiorina Giona
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Roberto Lisi
- Unità Operativa Dipartimentale Talassemia, Presidio Garibaldi-Centro ARNAS Garibaldi, Catania, Italy
| | - Paola Giordano
- UOC Pediatria Universitaria, Università di Bari, Bari, Italy
| | | | - Aldo Filosa
- UOSD Malattie rare del globulo rosso, AORN A. Cardarelli, Naples, Italy
| | - Sarah Marktel
- Hematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola Maroni
- Servizio di Immunoematologia e Medicina Trasfusionale, ASST Sette Laghi, Varese, Italy
| | - Mauro Murgia
- Centro Provinciale per le Microcitemia, Ospedale San Martino di Oristano, Oristano, Italy
| | - Raffaella Origa
- Ospedale Pediatrico Microcitemico, Università di Cagliari, Cagliari, Italy
| | - Filomena Longo
- Hematology, Thalassemia and Congenital Anemia Center, Ospedale Galliera, Genova, Italy
| | - Marta Bortolotti
- Department of Oncology and Oncohematology, University of Milan, Milan, Italy
| | - Raffaella Colombatti
- Dipartimento della Salute della Donna e del Bambino Azienda Ospedaliera, Azienda Ospedaliera Universitaria, Padova, Italy
| | - Rosario Di Maggio
- Unità Operativa Semplice Dipartimentale Talassemia P.O. Vittorio Emanuele, Gela, Italy
| | - Raffaella Mariani
- Rare Disease Centre - Hereditary anemias - ASST-Monza, S. Gerardo Hospital - University of Milano-Bicocca, Monza, Italy
| | - Alberto Piperno
- Rare Disease Centre - Hereditary anemias - ASST-Monza, S. Gerardo Hospital - University of Milano-Bicocca, Monza, Italy
| | - Paola Corti
- Pediatric Clinic Hemato-Oncology Department, University of Milano-Bicocca, MBBM Foundation, San Gerardo Hospital, Monza, Italy
| | - Carmelo Fidone
- Servizio Immunotrasfusionale, Azienda Ospedaliera Maria Paternò Arezzo, Ragusa, Italy
| | - Giovanni Palazzi
- Servizio Immunotrasfusionale, Azienda Ospedaliero Universitaria Modena, Modena, Italy
| | - Luca Badalamenti
- Biomedicina, Neuroscienze e Diagnostica avanzata, University of Palermo, Palermo, Italy
| | | | - Frédéric B. Piel
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Gian Luca Forni
- Italian Association of Pediatric Hematology Oncology (AIEOP) Coagulation Disorders Working Group, Brescia, Italy
- *Correspondence: Gian Luca Forni
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Ciriello D, Cieri‐Hutcherson NE, Seyse S, Abeles J, Conway‐Habes E, Slowik B, Woodruff AE. Evaluation of a pain management protocol used to deescalate opioid use in adult patients hospitalized with vaso‐occlusive crisis due to sickle cell disease. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2021. [DOI: 10.1002/jac5.1533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - Nicole E. Cieri‐Hutcherson
- Department of Pharmacy Practice University at Buffalo School of Pharmacy and Pharmaceutical Science Buffalo New York USA
| | | | - Jennifer Abeles
- Department of Medicine Jacobs School of Medicine & Biomedical Sciences, Buffalo General Medical Center, John R. Oishei Children's Hospital Buffalo New York USA
| | - Erin Conway‐Habes
- Department of Medicine Jacobs School of Medicine & Biomedical Sciences, Buffalo General Medical Center, John R. Oishei Children's Hospital Buffalo New York USA
| | - Baylie Slowik
- Department of Pharmacy Practice University at Buffalo School of Pharmacy and Pharmaceutical Science Buffalo New York USA
| | - Ashley E. Woodruff
- Department of Pharmacy Practice University at Buffalo School of Pharmacy and Pharmaceutical Science Buffalo New York USA
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Elenga N, Vantilcke V, Martin E, Cuadro E, Selles P, Basset T. Red blood cell exchange in children with sickle cell disease. Int J Hematol 2021; 115:107-113. [PMID: 34550539 DOI: 10.1007/s12185-021-03221-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 09/08/2021] [Accepted: 09/08/2021] [Indexed: 10/20/2022]
Abstract
The aim of our study was to assess the efficacy of red blood cell exchange (RBCx) using a Spectra Optia® automated apheresis system in children with sickle cell disease (SCD). We used automated RBCx to treat acute and chronic complications in 75 children with SCD who had a median age of 10 years [7-13]. We analyzed 649 RBCx sessions. Peripheral venous access was limited in a number of the children, and thus a femoral double-lumen central venous catheter was required. We recommend heparin locking with 500 units in each lumen of the catheter. To prevent complications, we ensured that all patients had achieved a post-RCE HbS level of < 30%. For chronic transfusion, with a post-RCE Hb level of approximately 10-11 g/dL, a blood exchange volume of ≥ 32 mL/kg, and an interval between each RBCx procedure of ≤ 30 days, the residual HbS level was maintained below 30%. For acute transfusion, a post-exchange Hb level ≥ 10 g/dL (p < 0.001) and a total exchange volume ≥ 35 mL/kg (p = 0.001) were the best way to reduce HbS to < 30%. AUC was 0.84. Our results show that erythrocytapheresis was useful and safe for children with SCD.
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Affiliation(s)
- Narcisse Elenga
- Sickle Cell Disease Center, Centre Hospitalier de Cayenne, Rue des Flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana. .,Centre Hospitalier de Cayenne, Rue des Flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana.
| | - Vincent Vantilcke
- Sickle Cell Disease Center, Centre Hospitalier de Cayenne, Rue des Flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana
| | - Elise Martin
- Centre Hospitalier de Cayenne, Rue des Flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana
| | - Emma Cuadro
- Centre Hospitalier de Cayenne, Rue des Flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana
| | - Pierre Selles
- Etablissement Français du Sang, Andrée Rosemon, Rue des Flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana
| | - Thierry Basset
- Centre Hospitalier de Cayenne, Rue des Flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana
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13
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Canatan D, Vives Corrons JL, Piacentini G, Kara F, Keskinkılıç B, Tezel B, Külekçi Uğur A, Babayiğit M, Krishnevskaya E, Millimaggi G, Erinekçi O, Özdemir Z, De Sanctis V. Immigration and screening programs for hemoglobinopathies in Italy, Spain and Turkey. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021410. [PMID: 34487057 PMCID: PMC8477095 DOI: 10.23750/abm.v92i4.11965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/04/2021] [Indexed: 11/23/2022]
Abstract
Sickle cell disease (SCD) and thalassemias are the most common monogenic diseases in the world. The number of migrants and refugees in Europe and Turkey, in the past decade, has increased dramatically due to war, violence or prosecutions in their homeland. Prevention and management of haemoglobin disorders is well established and managed in countries where these conditions were traditionally endemic or in countries that have a longstanding tradition of receiving migrants. Therefore, preventive and diagnostic programmes regarding hemoglobinopathies in immigrant populations have been implemented. The purpose of this paper it to report a summary of the experience gained in Italy, Spain and Turkey in migrants, asylum seekers and refugees.
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Affiliation(s)
- Duran Canatan
- Thalassemia Diagnosis Center of Mediterranean Blood Diseases Foundation, Antalya (Turkey).
| | - Joan Lluis Vives Corrons
- Red Blood Cell and Haematopoietic Disorders Unit, Institute for Leukemia Research Josep Carreras (IJC) and University of Barcelona, Catalonia (Spain).
| | | | - Fatih Kara
- General Directory of Public Health of MOH of Turkey, Ankara (Turkey) .
| | - Bekir Keskinkılıç
- General Directory of Public Health of MOH of Turkey, Ankara (Turkey) .
| | - Başak Tezel
- General Directory of Public Health of MOH of Turkey, Ankara (Turkey) .
| | | | - Meliha Babayiğit
- General Directory of Public Health of MOH of Turkey, Ankara (Turkey).
| | - Elena Krishnevskaya
- Red Blood Cell and Haematopoietic Disorders Unit, Institute for Leukemia Research Josep Carreras (IJC) and University of Barcelona, Catalonia (Spain).
| | | | - Ozlem Erinekçi
- Thalassemia Diagnosis Center of Mediterranean Blood Diseases Foundation, Antalya (Turkey).
| | - Zekiye Özdemir
- Thalassemia Diagnosis Center of Mediterranean Blood Diseases Foundation, Antalya (Turkey).
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Colombatti R, Casale M, Russo G. Disease burden and quality of life of in children with sickle cell disease in Italy: time to be considered a priority. Ital J Pediatr 2021; 47:163. [PMID: 34325732 PMCID: PMC8323323 DOI: 10.1186/s13052-021-01109-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/18/2021] [Indexed: 01/12/2023] Open
Abstract
The objective of the present article is to highlight the need for attention to Quality of Life of patients with Sickle Cell Disease living in Italy. The transformation of sickle cell disease from a severe life-threatening disease of childhood into a chronic, lifelong condition due to the significant improvements in care and treatment options, imposes increasing new challenges to health care providers and patients. Patients now face physical, psychosocial and emotional challenges throughout their lives. They generally have to receive chronic treatments and regular multidisciplinary monitoring which increase social and emotional burden rendering adherence to treatment sometimes complicated. A chronic disease impacts all aspects of patients’ lives, not only the physical one, but also the social and emotional aspects as well as the educational and working life. The entire “Quality of Life” is affected and recent evidence demonstrates the importance quality of life has for patients with chronic illness. The results of this review focus on emerging data regarding quality of life across the lifespan of patients with Sickle Cell Disease, and highlight the need for more action in this field in Italy, where recent immigration and improved care determine an increasing population of children with sickle cell disease being taken into long term care.
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Affiliation(s)
- Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child's Health, University of Padova, Padova, Italy
| | - Maddalena Casale
- Department of Women, Child and General and Specialized Surgery, University "Luigi Vanvitelli", Naples, Italy
| | - Giovanna Russo
- Pediatric Hemato-Oncology Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
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15
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Casale M, Di Maio N, Verde V, Scianguetta S, Di Girolamo MG, Tomeo R, Roberti D, Misso S, Perrotta S. Response to Measles, Mumps and Rubella (MMR) Vaccine in Transfusion-Dependent Patients. Vaccines (Basel) 2021; 9:vaccines9060561. [PMID: 34072263 PMCID: PMC8227230 DOI: 10.3390/vaccines9060561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 11/16/2022] Open
Abstract
Measles, mumps and rubella (MMR) still determine significant morbidity and mortality, although a highly effective vaccine is available. Postponing the MMR vaccination until 6 months after the last red blood cell (RBC) transfusion is recommended, but this delay is incompatible with chronic transfusions. The present study aimed at investigating the impact of blood transfusions on the immunogenicity of the MMR vaccine. In this observational study, a group of 45 transfusion- dependent (TD) patients was compared to 24 non-transfusion-dependent (NTD) patients. Immunity to measles was achieved in 35 (78%) TD and 21 (88%) NTD subjects (p = 0.7), to mumps in 36 (80%) TD and 21 (88%) NTD subjects (p = 0.99), and to rubella in 40 (89%) TD and 23 (96%) NTD subjects (p = 0.99). No significant difference was observed in the number of non-immune individuals or those with doubtful protection between the two groups (p > 0.05). The mean IgG value, assayed in 50 pre-storage leukoreduced RBC units, was 0.075 ± 0.064 mg/mL, ten times lower than the level assumed in blood units and considered detrimental to the immune response in TD patients. This work shows a favorable response to MMR vaccination in TD and NTDT patients and paves the way for further larger studies assessing the impact of chronic transfusions on vaccine response.
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Affiliation(s)
- Maddalena Casale
- Department of Women, Child and General and Specialized Surgery, University “Luigi Vanvitelli”, 80138 Naples, Italy; (N.D.M.); (V.V.); (S.S.); (D.R.); (S.P.)
- Correspondence: ; Tel.: +39-08-1566-5698
| | - Nicoletta Di Maio
- Department of Women, Child and General and Specialized Surgery, University “Luigi Vanvitelli”, 80138 Naples, Italy; (N.D.M.); (V.V.); (S.S.); (D.R.); (S.P.)
| | - Valentina Verde
- Department of Women, Child and General and Specialized Surgery, University “Luigi Vanvitelli”, 80138 Naples, Italy; (N.D.M.); (V.V.); (S.S.); (D.R.); (S.P.)
| | - Saverio Scianguetta
- Department of Women, Child and General and Specialized Surgery, University “Luigi Vanvitelli”, 80138 Naples, Italy; (N.D.M.); (V.V.); (S.S.); (D.R.); (S.P.)
| | | | - Rita Tomeo
- Immuno-Transfusion Service, ASL Caserta, 81031 Aversa, Italy; (M.G.D.G.); (R.T.); (S.M.)
| | - Domenico Roberti
- Department of Women, Child and General and Specialized Surgery, University “Luigi Vanvitelli”, 80138 Naples, Italy; (N.D.M.); (V.V.); (S.S.); (D.R.); (S.P.)
| | - Saverio Misso
- Immuno-Transfusion Service, ASL Caserta, 81031 Aversa, Italy; (M.G.D.G.); (R.T.); (S.M.)
| | - Silverio Perrotta
- Department of Women, Child and General and Specialized Surgery, University “Luigi Vanvitelli”, 80138 Naples, Italy; (N.D.M.); (V.V.); (S.S.); (D.R.); (S.P.)
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Gerardin M, Rousselet M, Couec ML, Masseau A, Guerlais M, Authier N, Deheul S, Roussin A, Micallef J, Djezzar S, Feuillet F, Jolliet P, Victorri-Vigneau C. Descriptive analysis of sickle cell patients living in France: The PHEDRE cross-sectional study. PLoS One 2021; 16:e0248649. [PMID: 33735176 PMCID: PMC7971579 DOI: 10.1371/journal.pone.0248649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 03/02/2021] [Indexed: 11/18/2022] Open
Abstract
Background Sickle cell disease (SCD) induces chronic haemolytic anaemia and intermittent vaso-occlusion that results in tissue ischaemia causing acute, severe pain episodes that can lead to frequent hospitalizations. These consequences can have repercussions on family, social, school and/or professional life. Here, we present some of the results of the PHEDRE study (Pharmacodépendance Et DREpanocytose—drug dependence and sickle-cell disease), which is the largest study of patients with SCD in France. This paper intends to describe characteristics of the French SCD population. We also aimed to assess the impact of the disease on the lives of patients using objective and subjective variables. Methods The PHEDRE study was a national multicentric observational study. Adults, adolescents and children with a confirmed SCD diagnosis were included in the study by their referring doctor. Then, they were interviewed by phone about their socioeconomic status, about the impact of the disease on their lives and about their analgesic and psychoactive drug use. Results The study population consisted of 872 patients (28% were minors). Seventy-two percent of adults were active, and all minors were in school. Many patients presented criteria of severe SCD. Seventy-five percent were homozygous SS, 15% were double heterozygotes SC and 8% were heterozygotes Sβthal, 87% received specific treatment, 58% were hospitalized at least once for vaso-occlusive crisis in the past 12 months, and the number of analgesic drugs taken averaged 3.8. Seventy-five percent of patients reported academic or professional consequences related to their SCD, and 52% reported social consequences. Conclusions The impact of SCD on patients’ lives can be significant, nevertheless their social integration seems to be maintained. We highlighted respect of recommendations regarding analgesic treatments and only a few patients used tobacco, alcohol or cannabis. Trial registration Clinical Trials, NCT02580565; https://clinicaltrials.gov/ Registered 16 October 2015.
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Affiliation(s)
- Marie Gerardin
- Service de Pharmacologie Clinique, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Morgane Rousselet
- Service de Pharmacologie Clinique, Centre Hospitalier Universitaire de Nantes, Nantes, France
- Service d’Addictologie et de Psychiatrie, Centre Hospitalier Universitaire de Nantes, Nantes, France
- INSERM U1246 SPHERE “Methods in Patient-Centered Outcomes and Health Research”, Universités de Nantes et Tours, Nantes, France
| | - Marie-Laure Couec
- Service de Pédiatrie et d’Oncologie Pédiatrique, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Agathe Masseau
- Service de Médecine Interne, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Marylène Guerlais
- Service de Pharmacologie Clinique, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Nicolas Authier
- Service de Pharmacologie Médicale, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Sylvie Deheul
- Service de Pharmacologie, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Anne Roussin
- Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Joelle Micallef
- Service de Pharmacologie Clinique, Hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Samira Djezzar
- Centre d’Evaluation et d’Information sur la Pharmacodependence—Addictovigilance de Paris, Hôpital Fernand Widal, APHP Paris, Paris, France
| | | | - Fanny Feuillet
- INSERM U1246 SPHERE “Methods in Patient-Centered Outcomes and Health Research”, Universités de Nantes et Tours, Nantes, France
- Plateforme de Biométrie, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Pascale Jolliet
- Service de Pharmacologie Clinique, Centre Hospitalier Universitaire de Nantes, Nantes, France
- INSERM U1246 SPHERE “Methods in Patient-Centered Outcomes and Health Research”, Universités de Nantes et Tours, Nantes, France
| | - Caroline Victorri-Vigneau
- Service de Pharmacologie Clinique, Centre Hospitalier Universitaire de Nantes, Nantes, France
- INSERM U1246 SPHERE “Methods in Patient-Centered Outcomes and Health Research”, Universités de Nantes et Tours, Nantes, France
- * E-mail:
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17
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Royal CDM, Babyak M, Shah N, Srivatsa S, Stewart KA, Tanabe P, Wonkam A, Asnani M. Sickle cell disease is a global prototype for integrative research and healthcare. ADVANCED GENETICS (HOBOKEN, N.J.) 2021; 2:e10037. [PMID: 36618444 PMCID: PMC9744540 DOI: 10.1002/ggn2.10037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 02/06/2023]
Abstract
Differences in health outcomes and treatment responses within and between global populations have been well documented. There is growing recognition of the need to move beyond simple inventories and descriptions of these differences and our linear explanations for them, and gain a better understanding of the multifaceted systems and networks underlying them in order to develop more precise and effective remedies. Typical targets for such integrative research have been common multifactorial diseases. We propose sickle cell disease, one of the most common monogenic diseases, as an ideal candidate for elucidating the complexity of the influences of endogenous and exogenous factors on disease pathophysiology, phenotypic diversity, and variations in responses to treatments at both the individual and population levels. We provide data-informed representations of diverse contributors to sickle cell disease complications that could guide innovative efforts to advance scientific knowledge, clinical practice, and policy formulation related to the disease; help improve outcomes for people worldwide with sickle cell disease; and inform approaches to studying and addressing other diseases.
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Affiliation(s)
- Charmaine D. M. Royal
- Department of African & African American StudiesDuke UniversityDurhamNorth CarolinaUSA,Duke Global Health InstituteDuke UniversityDurhamNorth CarolinaUSA,Center on Genomics, Race, Identity, DifferenceDuke UniversityDurhamNorth CarolinaUSA
| | - Michael Babyak
- Department of Psychiatry and Behavioral SciencesDuke University Medical CenterDurhamNorth CarolinaUSA
| | - Nirmish Shah
- Department of MedicineDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Shantanu Srivatsa
- Center on Genomics, Race, Identity, DifferenceDuke UniversityDurhamNorth CarolinaUSA
| | | | - Paula Tanabe
- Department of MedicineDuke University School of MedicineDurhamNorth CarolinaUSA,Duke University School of NursingDurhamNorth CarolinaUSA
| | - Ambroise Wonkam
- Division of Human Genetics, Department of Medicine, Faculty of Health SciencesUniversity of Cape TownCape TownSouth Africa,Faculty of Medicine and Biomedical SciencesUniversity of Yaoundé 1YaoundéCameroon
| | - Monika Asnani
- Caribbean Institute for Health Research ‐ Sickle Cell UnitThe University of the West IndiesKingstonJamaica
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Evidence-based dental management in the new era of sickle cell disease: A scoping review. J Am Dent Assoc 2020; 151:668-677.e9. [PMID: 32854869 DOI: 10.1016/j.adaj.2020.05.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 05/24/2020] [Accepted: 05/27/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Sickle cell disease (SCD) is an emerging global health issue with rapid progress in therapy especially since 2017. However, systematic reviews found no clinical trials on dental treatment of SCD. TYPES OF STUDIES REVIEWED Using a scoping review approach, the authors examined citations from 13 national SCD guidelines and 10 books spanning 4 decades. The authors also searched the following databases: PubMed, Cumulative Index to Nursing and Allied Health Literature, ScienceDirect, Scientific Electronic Library Online, and GoogleScholar. Eligibility criteria included SCD, oral health care and dental treatment, related to oral and systemic health, original data, or observations. RESULTS Systemic treatment of SCD might have opposing effects on caries, perhaps explaining the conflicting results published. Malocclusion correlates with marrow expansion. Other unusual orofacial findings reflect ischemia. Of 86 full-text articles examined, only 1, a Brazilian esthetic dentistry study, was a randomized clinical trial. No disease-specific data were found on risk of developing bacterial endocarditis, safety of inhaled nitrous oxide, safety of epinephrine with local anesthetic, or the benefit of comprehensive oral health care. PRACTICAL IMPLICATIONS In SCD, oral health and systemic health could be strongly linked. Penicillin, vaccines, and hydroxyurea might impact caries and bone. The interaction of SCD treatments and oral health merit study.
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Kehinde TA, Osundiji MA. Sickle cell trait and the potential risk of severe coronavirus disease 2019-A mini-review. Eur J Haematol 2020; 105:519-523. [PMID: 32589774 PMCID: PMC7361772 DOI: 10.1111/ejh.13478] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/22/2020] [Accepted: 06/22/2020] [Indexed: 12/14/2022]
Abstract
Coronavirus Disease 2019 (COVID‐19) pandemic is a rapidly evolving public health problem. The severity of COVID‐19 cases reported hitherto has varied greatly from asymptomatic to severe pneumonia and thromboembolism with subsequent mortality. An improved understanding of risk factors for adverse clinical outcomes may shed some light on novel personalized approaches to optimize clinical care in vulnerable populations. Emerging trends in the United States suggest possibly higher mortality rates of COVID‐19 among African Americans, although detailed epidemiological study data is pending. Sickle cell disease (SCD) disproportionately affects Black/African Americans in the United States as well as forebearers from sub‐Saharan Africa, the Western Hemisphere (South America, the Caribbean, and Central America), and some Mediterranean countries. The carrier frequency for SCD is high among African Americans. This article underscores the putative risks that may be associated with COVID‐19 pneumonia in sickle cell trait as well as potential opportunities for individualized medical care in the burgeoning era of personalized medicine.
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Affiliation(s)
| | - Mayowa Azeez Osundiji
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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Notarangelo LD, Agostini A, Casale M, Samperi P, Arcioni F, Gorello P, Perrotta S, Masera N, Barone A, Bertoni E, Bonetti E, Burnelli R, Casini T, Del Vecchio GC, Filippini B, Giona F, Giordano P, Gorio C, Marchina E, Nardi M, Petrone A, Colombatti R, Sainati L, Russo G. HbS/β+ thalassemia: Really a mild disease? A National survey from the AIEOP Sickle Cell Disease Study Group with genotype-phenotype correlation. Eur J Haematol 2019; 104:214-222. [PMID: 31788855 DOI: 10.1111/ejh.13362] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES HbS/β+ patients' presence in Italy increased due to immigration; these patients are clinically heterogeneous, and specific guidelines are lacking. Our aim is to describe a cohort of HbS/β+ patients, with genotype-phenotype correlation, in order to offer guidance for clinical management of such patients. METHODS Retrospective cohort study of HbS/β+ patients among 15 AIEOP Centres. RESULTS A total of 41 molecularly confirmed S/β+ patients were enrolled (1-55 years, median 10.9) and classified on β+ mutation: IVS-I-110, IVS-I-6, promoter, and "others." Prediagnostic events included VOC 16/41 (39%), ACS 6/41 (14.6%), sepsis 3/41 (3.7%), and avascular necrosis 3/41 (7,3%). Postdiagnostic events were VOC 22/41 (53.6% %), sepsis 4/41 (9.7%), ACS 4/41 (9.7%), avascular necrosis 3/41 (7.3%), aplastic crisis 2/41 (4.8%), stroke 1/41 (2.4%), ACS 1/41 (2.4%), and skin ulcerations 1/41 (2.4%). The IVS-I-110 group presented the lowest median age at first SCD-related event (P = .02 vs promoter group) and the higher median number of severe events/year (0.26 events/patient/year) (P = .01 vs IVS-I-6 and promoter groups). Promoter group presented a specific skeletal phenotype. Treatment regimen applied was variable among the centers. CONCLUSIONS HbS/β+ is not always a mild disease. Patients with IVS-I-110 mutation could benefit from a standard of care like SS and S/β° patients. Standardization of treatment is needed.
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Affiliation(s)
| | - Annalisa Agostini
- Pediatrics Clinic, University of Brescia, Spedali Civili di Brescia, Brescia, Italy
| | - Maddalena Casale
- Department of Woman, Child and General and Specialist Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Piera Samperi
- Unit of Pediatric Hematology and Oncology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Francesco Arcioni
- Pediatric Hematology and Oncology with Bone Marrow Transplation, Azienda Ospedaliera di Perugia, Perugia, Italy
| | - Paolo Gorello
- Department of Medicine, University of Perugia, CREO, Hematology, Perugia, Italy
| | - Silverio Perrotta
- Department of Woman, Child and General and Specialist Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Nicoletta Masera
- Department of Pediatrics, Università di Milano Bicocca, Fondazione MBBM, Monza, Italy
| | - Angelica Barone
- Department of Pediatric Onco-Hematology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Elisa Bertoni
- Hematology Oncology Unit, Children's Hospital, ASST Spedali Civili, Brescia, Italy
| | - Elisa Bonetti
- Department of Pediatric Onco-Hematology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Roberta Burnelli
- Pediatric Oncology University Hospital, Sant'Anna Hospital, Ferrara, Italy
| | - Tommaso Casini
- Pediatric Hematology-Oncology, IRCCS Meyer Children's Hospital, Florence, Italy
| | - Giovanni Carlo Del Vecchio
- Pediatric Unit "F. Vecchio", Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | | | - Fiorina Giona
- Department of Cellular Biotechnologies and Hematology, Policlinico Umberto I, Sapienza University, Hematology, Rome, Italy
| | - Paola Giordano
- Pediatric Unit "F. Vecchio", Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Chiara Gorio
- Hematology Oncology Unit, Children's Hospital, ASST Spedali Civili, Brescia, Italy
| | - Eleonora Marchina
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Margherita Nardi
- Onco-Hematologic Pediatric Center, University Hospital of Pisa, Pisa, Italy
| | - Angela Petrone
- Department of Pediatrics, Rovereto Hospital, Rovereto, Italy
| | - Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Laura Sainati
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Giovanna Russo
- Unit of Pediatric Hematology and Oncology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Casale M, Cozzolino F, Scianguetta S, Pucci P, Monaco V, Sanchez G, Santoro C, Rubino R, Cannata M, Perrotta S. Hb Vanvitelli: A new unstable α-globin chain variant causes undiagnosed chronic haemolytic anaemia when co-inherited with deletion − α3.7. Clin Biochem 2019; 74:80-85. [DOI: 10.1016/j.clinbiochem.2019.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/02/2019] [Accepted: 09/03/2019] [Indexed: 01/26/2023]
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