Time to rethink haemoglobin threshold guidelines in sickle cell disease

Samir K. Ballas*, Frans A. Kuypers, Victor R. Gordeuk, Jane S. Hankins, Alexis A. Thompson, Elliott Vichinsky

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Alleviating anaemia in patients with sickle cell disease (SCD) is crucial in managing acute complications, mitigating end-organ damage and preventing early mortality. Some disease-modifying and curative therapies have increased haemoglobin (Hb) levels to exceed 100 g/l, a threshold above which complications from red blood cell (RBC) transfusions have occurred, raising concern about whole-blood viscosity-related complications with these therapies. Here we discuss the rationale behind this limit, the effect of viscosity on blood flow and the applicability of this Hb threshold to therapies for SCD beyond RBC transfusions.

Original languageEnglish (US)
Pages (from-to)518-522
Number of pages5
JournalBritish Journal of Haematology
Issue number4
StatePublished - Nov 2021


  • blood transfusion
  • hydroxycarbamide
  • hyperviscosity
  • sickle cell disease
  • voxelotor

ASJC Scopus subject areas

  • Hematology


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