Nucleated Red Blood Cells in Children with Sickle Cell Disease Hospitalized for Pain

Josiah D. Ballantine, Soyang Kwon, Robert I Liem*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Acute chest syndrome (ACS) and transfusion requirements are common and difficult to predict during hospitalizations for acute vaso-occlusive episodes (VOE) among individuals with sickle cell disease (SCD). This study examined the relationship between nucleated red blood cell (NRBC) counts during hospitalization for VOE and development of ACS or transfusion requirement among children with SCD. Retrospective chart review was performed for 264 encounters of patients with SCD hospitalized for uncomplicated VOE who had NRBC count data at admission during a 5-year period. Multivariable logistic regression analysis was conducted to determine the relationship of admission and change in NRBC (ΔNRBC) to ACS/transfusion requirement. Overall, 44 of 264 (16.7%) encounters resulted in ACS, transfusion, or both. Admission NRBC was not associated with development of ACS/transfusion requirement. Among 125 of 264 (47.3%) encounters in which a subsequent CBC was obtained, greater increases in NRBCs and greater decrease in hemoglobin were significantly associated with ACS/transfusion requirement (OR, 2.72; 95% CI, 1.16, 6.35; P=0.02 and OR, 2.52; 95% CI, 1.08, 5.89; P=0.03, respectively). Our finding that an increase in NRBC counts was associated with development of ACS/transfusion requirement suggests that ΔNRBCs may represent a useful biomarker for predicting complications in children with SCD hospitalized for VOE.

Original languageEnglish (US)
Pages (from-to)E487-E492
JournalJournal of pediatric hematology/oncology
Issue number8
StatePublished - Nov 1 2019


  • acute chest syndrome
  • nucleated red blood cells
  • sickle cell disease
  • sickle cell pain
  • transfusion

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology


Dive into the research topics of 'Nucleated Red Blood Cells in Children with Sickle Cell Disease Hospitalized for Pain'. Together they form a unique fingerprint.

Cite this