Red blood cell transfusion to treat or prevent complications in sickle cell disease: an overview of Cochrane reviews.
Cochrane Database Syst RevSep 24, 2026 (epub)
Clinical ResearchHematology
Alvin M Katumba, Carolyn Dorée, Lise J Estcourt
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In 30 seconds
This systematic review and meta-analysis evaluated the efficacy of red blood cell (RBC) transfusions in treating or preventing complications in sickle cell disease (SCD) across 17 Cochrane reviews. The analysis included 1502 participants and found that long-term RBC transfusions likely reduce the risk of stroke (RR 0.12) in high-risk children, while evidence for other outcomes was of very-low certainty.
Key findings
- Long-term RBC transfusions likely decrease the risk of stroke (RR 0.12, 95% CI 0.03 to 0.49) in high-risk children.
- Long-term RBC transfusions may reduce the risk of acute chest syndrome (RR 0.24, 95% CI 0.12 to 0.48).
- Long-term RBC transfusions may decrease the risk of painful crises (RR 0.62, 95% CI 0.46 to 0.84).
- Most evidence for transfusion-related outcomes was of very-low certainty.
Why it matters
Understanding the benefits and risks of RBC transfusions in SCD is crucial for clinicians to make informed decisions about treatment strategies, particularly in high-risk populations where complications can lead to significant morbidity.