(P-TA-10) Multi-Center Study Correlating Laboratory Parameters of Sickle Cell Patients Undergoing Red Cell Exchange with Complications and Frequency of Hospitalization
Montefiore Medical Center Bronx, New York, United States
Background/Case Studies: Sickle cell disease (SCD) is a group of inherited hemoglobinopathies characterized by the presence of hemoglobin S, leading to chronichemolysis, vaso-occlusion, and impaired oxygen delivery. Management often involves regular blood transfusions, which can result in iron overload, or red cell exchange. Ferritin, an iron-storage protein and acute-phase reactant, is used as a surrogate marker for body iron levels, but its interpretation in SCD is complicated due to chronic inflammation. The relationship between ferritin levels and key clinical outcomes in SCD patients undergoing red cell exchange remains underexplored. This study aims to evaluate the association between ferritin, cholesterol, and triglyceride levels and clinical outcomes in SCD patients undergoing regular red cell exchange in both adult and pediatrics.
Study
Design/Methods: A retrospective, observational cohort study utilizing clinical data from one of the largest SCD populations in the United States was conducted at a medical center with SCD patients receiving monthly red cell exchange. Data including demographic information, ferritin levels, RBC indices, clinical outcomes such as vaso-occlusive crisis, acute chest syndrome, and stroke were extracted.
Results/Findings: 40 adults and 17 pediatric patients were included. For the adult population, 3 patients had low ferritin, 5 had normal ferritin, 27 high ferritin, and 5 cases were excluded. As for the pediatrics cases, all 17 patients had high ferritin thus they were excluded due to lack of comparison group.
Ferritin levels showed a statistically significant correlation with hospital admissions (p=0.0001). Lower ferritin levels were associated with a decreased likelihood of hospital admission.
Cholesterol levels and hospital admissions (p=0.9944).
Triglyceride levels and hospital admissions (p=0.2410).
These findings suggest that ferritin levels may serve as a valuable predictor of hospital admissions in SCD patients undergoing red cell exchange in the adult population. The inverse relationship between ferritin levels and hospital admissions could indicate that better iron management or lower iron burden may lead to improved clinical outcomes in these patients. However, lipid profiles do not appear to have a significant impact on hospital admission rates.
Conclusions: These results provide important insights for clinical management and future research directions in SCD, particularly in the context of iron homeostasis and its impact on disease severity and healthcare utilization.
