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<p>To evaluate the impact of automated red cell exchange (ARCE) on clinical outcomes and laboratory parameters in patients with sickle cell disease presenting with acute and chronic complications. This single-center pre–post interventional observational study included 39 patients with sickle cell disease undergoing automated red cell exchange for indications categorized under the American Society for Apheresis (ASFA) Categories I–III. Procedures were performed using a continuous-flow centrifugation-based apheresis system with leukoreduced, Rh- and Kell-antigen–matched red cell concentrates. The target hemoglobin S (HbS) level was set at &lt; 30%. Clinical parameters, hematological indices, HbS levels, and biochemical markers of hemolysis were assessed before and after the procedure. Statistical analysis was performed using SPSS version 25, with significance set at <i>p</i> &lt; 0.05. Confidence intervals (95% CI) were calculated for key variables. The study population comprised 23 males (59.0%) and 16 females (41.0%), with a mean age of 21.23 ± 5.84 years. Mean pre-procedure HbS levels declined significantly from 74.48 ± 8.74% (95% CI: 71.74–77.22) to 16.15 ± 3.65% (95% CI: 15.00–17.30) following automated red cell exchange (<i>p</i> &lt; 0.0001), achieving target levels in the majority of patients. Hemoglobin levels increased significantly, while markers of hemolysis and hepatic dysfunction demonstrated marked post-procedure improvement (<i>p</i> &lt; 0.0001). Pain scores, neurological status, oxygenation parameters, and organ dysfunction scores showed significant clinical improvement. The mean duration of hospital stay was 4.92 ± 1.38 days. No procedure-related mortality was observed. Automated red cell exchange is a safe and effective therapeutic modality in sickle cell disease, achieving rapid reduction in hemoglobin S levels and significant improvement in clinical and laboratory parameters.</p>

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Impact of Automated Red Cell Exchange on Clinical and Laboratory Parameters in Sickle Cell Patients

  • 期刊论文

  • 发表日期：

    2026年6月30日

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  • Akash Sharma,
  • Atul Shende,
  • Krishan Pathak,
  • Vaibhav Gupta,
  • Krishna Gupta

摘要

To evaluate the impact of automated red cell exchange (ARCE) on clinical outcomes and laboratory parameters in patients with sickle cell disease presenting with acute and chronic complications. This single-center pre–post interventional observational study included 39 patients with sickle cell disease undergoing automated red cell exchange for indications categorized under the American Society for Apheresis (ASFA) Categories I–III. Procedures were performed using a continuous-flow centrifugation-based apheresis system with leukoreduced, Rh- and Kell-antigen–matched red cell concentrates. The target hemoglobin S (HbS) level was set at < 30%. Clinical parameters, hematological indices, HbS levels, and biochemical markers of hemolysis were assessed before and after the procedure. Statistical analysis was performed using SPSS version 25, with significance set at p < 0.05. Confidence intervals (95% CI) were calculated for key variables. The study population comprised 23 males (59.0%) and 16 females (41.0%), with a mean age of 21.23 ± 5.84 years. Mean pre-procedure HbS levels declined significantly from 74.48 ± 8.74% (95% CI: 71.74–77.22) to 16.15 ± 3.65% (95% CI: 15.00–17.30) following automated red cell exchange (p < 0.0001), achieving target levels in the majority of patients. Hemoglobin levels increased significantly, while markers of hemolysis and hepatic dysfunction demonstrated marked post-procedure improvement (p < 0.0001). Pain scores, neurological status, oxygenation parameters, and organ dysfunction scores showed significant clinical improvement. The mean duration of hospital stay was 4.92 ± 1.38 days. No procedure-related mortality was observed. Automated red cell exchange is a safe and effective therapeutic modality in sickle cell disease, achieving rapid reduction in hemoglobin S levels and significant improvement in clinical and laboratory parameters.