{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:25:10Z","timestamp":1786976710982,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2013,8,30]],"date-time":"2013-08-30T00:00:00Z","timestamp":1377820800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"National Heart, Lung and Blood Institute\/National Institutes of Health","award":["NCT00122980"],"award-info":[{"award-number":["NCT00122980"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:p>\n                    To compare the non\u2010neurological events in children with sickle cell anemia (SCA) and previous stroke enrolled in SWiTCH. The NHLBI\u2010sponsored Phase III multicenter randomized clinical trial stroke with transfusions changing to hydroxyurea (SWiTCH) (\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                    NCT00122980) compared continuation of chronic blood transfusion\/iron chelation to switching to hydroxyurea\/phlebotomy for secondary stroke prevention and management of iron overload. All randomized children were included in the analysis (intention to treat). The Fisher's Exact test was used to compare the frequency of subjects who experienced at least one SCA\u2010related adverse event (AE) or serious adverse event (SAE) in each arm and to compare event rates. One hundred and thirty three subjects, mean age 13 \u00b1 3.9 years (range 5.2\u201319.0 years) and mean time of 7 years on chronic transfusion at study entry, were randomized and treated. Numbers of subjects experiencing non\u2010neurological AEs were similar in the two treatment arms, including SCA\u2010related events, SCA pain events, and low rates of acute chest syndrome and infection. However, fewer children continuing transfusion\/chelation experienced SAEs (\n                    <jats:italic>P<\/jats:italic>\n                    = 0.012), SCA\u2010related SAEs (\n                    <jats:italic>P<\/jats:italic>\n                    = 0.003), and SCA pain SAEs (\n                    <jats:italic>P<\/jats:italic>\n                    = 0.016) as compared to children on the hydroxyurea\/phlebotomy arm. The timing of phlebotomy did not influence SAEs. Older age at baseline predicted having at least 1 SCA pain event. Patients with recurrent neurological events during SWiTCH were not more likely to experience pain. In children with SCA and prior stroke, monthly transfusions and daily iron chelation provided superior protection against acute vaso\u2010occlusive pain SAEs when compared to hydroxyurea and monthly phlebotomy. Am. J. Heamtol. 88:932\u2013938, 2013. \u00a9 2013 Wiley Periodicals, Inc.\n                  <\/jats:p>","DOI":"10.1002\/ajh.23547","type":"journal-article","created":{"date-parts":[[2013,7,16]],"date-time":"2013-07-16T17:10:41Z","timestamp":1373994641000},"page":"932-938","source":"Crossref","is-referenced-by-count":43,"title":["Pain and other non\u2010neurological adverse events in children with sickle cell anemia and previous stroke who received hydroxyurea and phlebotomy or chronic transfusions and chelation: Results from the SWiTCH clinical trial"],"prefix":"10.1002","volume":"88","author":[{"given":"Ofelia","family":"Alvarez","sequence":"first","affiliation":[{"name":"Department of Pediatrics Division of Pediatric Hematology University of Miami Miami Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy A.","family":"Yovetich","sequence":"additional","affiliation":[{"name":"Rho Federal Systems Division, Inc. Chapel Hill North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Paul","family":"Scott","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology Medical College of Wisconsin Milwaukee Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Owen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology\/Oncology Children's Cancer and Blood Disorders Center\/Children's Hospital of King's Daughters Norfolk Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott T.","family":"Miller","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology\/Oncology SUNY\u2013Downstate\/Kings County Hospital Center Brooklyn New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Schultz","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology Cincinnati Children's Hospital Cincinnati Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Lockhart","sequence":"additional","affiliation":[{"name":"Rho Federal Systems Division, Inc. Chapel Hill North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Banu","family":"Aygun","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Pediatric Hematology\/Oncology and Stem Cell Transplantation Cohen Children's Medical Center of New York New Hyde Park New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Flanagan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Baylor College of Medicine Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Bonner","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Duke University Medical Center Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitta U.","family":"Mueller","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Baylor College of Medicine Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell E.","family":"Ware","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology Cincinnati Children's Hospital Cincinnati Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Investigators of the Stroke With Transfusions Changing to Hydroxyurea Clinical Trial 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