Blood transfusions halve 'silent' strokes from sickle cell

A study involving patients from Evelina London Children’s Hospital has found that monthly blood transfusions can cut the risk of ‘silent’ strokes in children with sickle cell anemia by 50%.

Sickle cell anemia is a genetic disorder where red blood cells are abnormally shaped. They are stickier than normal red blood cells and can block blood flow to the brain causing silent strokes. Unlike typical stokes, silent strokes have no obvious symptoms but may affect a child’s learning ability and IQ.

More than 196 children with sickle cell anemia from across the world, including 15 Evelina London patients, took part in the study, which has shown that receiving regular blood transfusions helps to prevent silent strokes in children with the condition:

• 14.4% of the children receiving standard medical care had a typical or silent stroke
• 6.1% of the children who received regular blood transfusions had a typical or silent stroke.  

Dr Baba Inusa, lead sickle cell consultant at Evelina London Children’s Hospital, says: “Now this study is complete we can begin offering the option of regular blood transfusions to our sickle cell anemia patients who have had silent strokes.

“Nearly all of our patients that took part in the trial have chosen to keep having blood transfusions because of the positive effect it has on their life.

“Detecting a silent stroke is important because having one increases the risk of further strokes. The oxygen deprivation caused by silent strokes can have a long-term impact on a child’s cognitive development and affect their school performance.

“This study provides clear evidence that children with this disease should be screened for silent strokes, so they can be referred to a neurologist as early as possible.”

The study was funded by the National Institutes of Health (NIH). The findings were published in the New England Journal of Medicine.