AABB23: Red Cell Exchange May Offer Additional Benefits for Patients With Sickle Cell Disease

In addition to helping to lower hemoglobin levels, a red cell exchange may also help to modulate immune responses and the inflammatory process in patients with sickle cell disease, according to new research presented at Monday afternoon’s oral abstract session on blood components and apheresis.

The data, presented by Kimmy Boyle, lab technician at Duke University Medical Center, support previous studies indicating that hyper-reactive neutrophils may be more common in patients with sickle cell disease.

Boyle noted that previous research indicated that in patients with sickle cell disease, neutrophils may have enhanced susceptibility to activation and play a role in contributing to vaso-occlusion and inflammation. However, this is the first study to demonstrate that red cell exchange may help to reduce neutrophil response in patients with sickle cell disease. Boyle said that red cell exchanges can help to modulate patients’ neutrophil responsiveness, thus resulting in reduced inflammatory activity.

Boyle and her colleagues studied whole blood obtained from patients with sickle cell disease before and after they underwent outpatient red cell exchange (for non-acute indications). The results showed that neutrophil activation increased in patients with sickle cell disease compared with age- and sex-matched healthy controls.

To determine if red cell exchange would affect patients’ neutrophil degranulation responses, the researchers obtained whole blood before and after apheresis from patients who underwent red cell exchange. The results showed that neutrophil release decreased after red cell exchange in all patients. In addition, degranulation responses were correlated with hemoglobin levels.