Objective: To determine whether long-term transfusion improves growth in chil dren with sickle cell anemia. Study design: In the Stroke Prevention Trial for S ickle Cell Anemia Study, patients were randomized to receive long-term transfus ion (CTX) or standard care (STC). Transfusions were administered every 3 to 5 we eks, and hemoglobin S levels were maintained at 30%pretransfusion for an averag e of 2 years. Serial height and weight measurements (obtained every 3 months), b ody mass index (BMI) values, and growth z-scores were analyzed. Results: Children in the CTX (n = 53) and STC (n = 41) groups were similar at baseline. After 24 months, the z-scores for height, weight, and BMI of those receiving CTX had improved signi ficantly, whereas no changes occurred in the STC group. Patients in the CTX grou p approached normal height-for-age and weight-for-age z-scores. Patients fr om a large historical control group had significantly lower weight and height gr owth velocities than patients in the CTX group. Conclusions: Patients in the Str oke Prevention Trial for Sickle Cell Anemia Study who received CTX had improved height and weight and BMI over a 2-year period. Higher hemoglobin levels result ing from transfusion may improve growth by lowering energy expenditure. In addit ion to the prevention of vasoocclusive events, CTX results in significant improv ement in the growth of children with sickle cell disease.
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