Clinical research studyVenous Thromboembolism in Adults with Sickle Cell Disease: A Serious and Under-recognized Complication
Section snippets
Methods
We conducted a retrospective cross-sectional study of sickle cell patients cared for at the Sickle Cell Center for Adults at Johns Hopkins between August 2008 and January 2012. Inclusion criteria included an age ≥18 years and a known genotype. Patients who had undergone successful bone marrow transplant before the study period were not included. The study was approved by the Institutional Review Board and was determined to be exempt from informed consent.
Data were collected via review of
Patient Characteristics
Five hundred three patients were seen in the Sickle Cell Center for Adults at Johns Hopkins from August 2008 to January 2012. Of those patients, 4 had unknown genotype and 2 had undergone successful bone marrow transplant and therefore were excluded. Of the remaining 497 patients, 404 (81.3%) had complete data on venous thromboembolism history and relevant comorbidities for analysis. Within our cohort, 69% (279/404) had sickle cell anemia genotypes. Of the 125 patients with sickle variant
Discussion
Venous thromboembolism is not generally recognized as a common comorbidity in sickle cell patients. In fact, venous thromboembolism has not been included in comprehensive reviews of complications associated with sickle cell disease.24, 26 We found that 25% of adult patients with sickle cell disease have a history of a venous thromboembolism, a prevalence that is similar to that seen at baseline in family studies of patients with strong thrombophilic defects such as antithrombin, protein C, and
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Funding: National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH) 2K12 HL087169-06 (RPN), 1K01HL108832-01 (CH), K23HL083089-03 (SL).
Conflict of Interest: MBS has provided consulting services to Sanofi-Aventis, Daiichi-Sakyo, Eisai, and Janseen HealthCare; has received honoraria from Sanofi-Aventis and Ortho-McNeil; has received funding from Bristol-Myers-Squibb; and has provided expert testimony relating to thrombosis. SL serves on the scientific advisory board for Hemaquest.
Authorship: All authors had access to the data and played a role in writing this manuscript.