Chronic transfusions in patients with sickle cell disease. Indications and problems.

The use of chronic transfusions in patients with sickle cell disease is now the common practice after a stroke has occurred, in order to prevent the highly probable recurrence. Clinical studies show that chronic transfusion prevents the recurrence of a stroke. Review of the natural history of sickle cell disease indicates, however, that the mortality and morbidity associated with hemoglobin SS disease are quite high. Use of chronic transfusion, given before the occurrence of stroke and other irreversible organ damage, can be considered as an alternative to the conservative management of sickle cell disease. Chronic transfusion has become practicable since the recent advances in chelation therapy have essentially eliminated the risk of secondary iron overload.