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Two With Sickle Cell Have Stroke When Transfusions End

Study terminated early because of adverse events

THURSDAY, Dec. 29 (HealthDay News) -- Children with sickle cell disease who discontinue prophylactic blood transfusions often develop abnormal transcranial blood flow and are at high risk for stroke, according to a report in the Dec. 29 issue of the New England Journal of Medicine.

Robert J. Adams, M.D., of the Medical College of Georgia, and investigators from the Optimizing Primary Stroke Prevention in Sickle Cell Anemia (STOP 2) Trial randomized 100 children at high risk of stroke to either continue or discontinue transfusions.

The researchers stopped the study after 14 of 41 children who discontinued transfusions developed high risk Doppler readings and another two experienced a stroke within an average of 4.5 months. Seventy-nine children were enrolled at the study's termination, and none of the 38 children who continued to receive transfusions suffered an event.

"Given the transfusion dependence demonstrated in the STOP 2 study, and given the problems associated with long-term transfusion to prevent stroke, stem-cell transplantation should be considered as an option for primary stroke prevention," the authors conclude.

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