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 journalArticle

Abstract

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)
JournalJournal of pediatric hematology/oncology
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

Fingerprint

Acute Chest Syndrome
Sickle Cell Anemia
Erythrocytes
Pain
Erythrocyte Count
Hospitalization
Hemoglobins
Biomarkers
Logistic Models
Regression Analysis

Keywords

  • 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

Cite this

@article{c86b05a683b845f8b14aee94152bf194,
title = "Nucleated Red Blood Cells in Children with Sickle Cell Disease Hospitalized for Pain",
abstract = "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.",
keywords = "acute chest syndrome, nucleated red blood cells, sickle cell disease, sickle cell pain, transfusion",
author = "Ballantine, {Josiah D.} and Soyang Kwon and Liem, {Robert I}",
year = "2019",
month = "1",
day = "1",
doi = "10.1097/MPH.0000000000001467",
language = "English (US)",
journal = "Journal of Pediatric Hematology/Oncology",
issn = "1077-4114",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Nucleated Red Blood Cells in Children with Sickle Cell Disease Hospitalized for Pain

AU - Ballantine, Josiah D.

AU - Kwon, Soyang

AU - Liem, Robert I

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

KW - acute chest syndrome

KW - nucleated red blood cells

KW - sickle cell disease

KW - sickle cell pain

KW - transfusion

UR - http://www.scopus.com/inward/record.url?scp=85064199512&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85064199512&partnerID=8YFLogxK

U2 - 10.1097/MPH.0000000000001467

DO - 10.1097/MPH.0000000000001467

M3 - Article

JO - Journal of Pediatric Hematology/Oncology

JF - Journal of Pediatric Hematology/Oncology

SN - 1077-4114

ER -