Red blood cell transfusion to treat or prevent complications in sickle cell disease: an overview of Cochrane reviews

Sickle cell disease is a severe genetic disorder that can cause severe pain, organ damage, and premature death. Red blood cell transfusions are used to treat complications of sickle cell disease or as a long-term programme to prevent its complications. This overview analysed 17 Cochrane reviews, of which five contained data from nine clinical trials with 1502 participants. Results showed that long-term transfusions probably reduce the risk of stroke in children and adolescents at high risk (moderate certainty of evidence) and may reduce the risk of painful crises and acute chest syndrome. In children with normal transcranial doppler velocities, however, transfusions may increase the risk of iron overload. In all comparisons, there was little or no difference in the risk of death. Most evidence had very low or low certainty of evidence.