{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:10:06Z","timestamp":1789017006848,"version":"build-2803163510"},"reference-count":48,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Although circulating nucleated red blood cells (cNRBCs) have previously been detected in patients with sickle cell disease (SCD), their prevalence and clinical significance during steady\u2010state disease have not been established. We retrospectively analyzed 270 adults with an SS or S\u03b2\n                    <jats:sup>0<\/jats:sup>\n                    \u2010thalassemia genotype. cNRBCs were counted during steady\u2010state disease. Patients were classified as high cNRBC+ (&gt;\u20093 per 100 white blood cells (WBCs)), low cNRBC+ (1\u20133 per 100 WBCs), or cNRBC\u2212 (no cNRBCs). cNRBC+ and cNRBC\u2212 patients were compared with regard to clinical and laboratory data and in\u00a0vitro erythroid differentiation from peripheral blood CD34+ cells. cNRBCs were detected in 65.6% of the patients and encompassed all terminal erythroid stages. High cNRBC+ patients were more likely to be receiving hydroxyurea (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.024). cNRBC+ patients exhibited a lower median [IQR] hemoglobin level (8.8 [7.8\u201310] and 8.4 [7.4\u20139.4] in the high and low cNRBC+ groups, respectively vs. 9.3 [8.3\u20139.9] g\/dL in the cNRBC\u2212 group;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.024). The cNRBC+ percentage was correlated negatively with the reticulocyte and WBC counts and positively with the mean corpuscular volume and the ferritin level. Clinically, a trend toward a greater likelihood of acute chest syndrome was observed in cNRBC+ patients. High cNRBC+ patients' cells exhibited accelerated erythroid differentiation in\u00a0vitro, suggestive of dyserythropoiesis. cNRBCs constitute a common, easily measurable marker of a distinct hematological phenotype in adult patients with SCD: more severe anemia and signs of dyserythropoiesis. Prospective studies are needed to determine the value of the cNRBC percentage for predicting disease severity and guiding the treatment of dyserythropoiesis.\n                  <\/jats:p>","DOI":"10.1002\/ajh.70497","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:51:06Z","timestamp":1789015866000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Presence and Percentage of Circulating Nucleated Red Blood Cells Reveal Distinct Characteristics in Adults With Sickle Cell Disease"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6510-6611","authenticated-orcid":false,"given":"Ugo","family":"Boccadifuoco","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, French Sickle Cell Disease Referral Center AP\u2010HP, H\u00f4pital Europ\u00e9en Georges Pompidou  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5466-1707","authenticated-orcid":false,"given":"Ivan","family":"Lerner","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics AP\u2010HP, H\u00f4pital Europ\u00e9en Georges Pompidou  Paris France"},{"name":"Universit\u00e9 Paris Cit\u00e9, Sorbonne Universit\u00e9 INSERM UMR\u2010S 1138, Centre de Recherche des Cordeliers  Paris France"},{"name":"HeKA, INRIA Paris  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Auria","family":"Godard","sequence":"additional","affiliation":[{"name":"Initiatives IdEx Globule Rouge d'Excellence (InIdex GR\u2010Ex), Universit\u00e9 Paris Cit\u00e9  Paris France"},{"name":"Aix Marseille Universit\u00e9 CNRS, EFS, ADES  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3210-2821","authenticated-orcid":false,"given":"Luc","family":"Darnige","sequence":"additional","affiliation":[{"name":"Service d'h\u00e9matologie biologique AP\u2010HP, H\u00f4pital Europ\u00e9en Georges Pompidou  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laure","family":"Joseph","sequence":"additional","affiliation":[{"name":"Initiatives IdEx Globule Rouge d'Excellence (InIdex GR\u2010Ex), Universit\u00e9 Paris Cit\u00e9  Paris France"},{"name":"Service de Bioth\u00e9rapie H\u00f4pital Universitaire Necker Enfants Malades  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8184-427X","authenticated-orcid":false,"given":"Wassim","family":"El Nemer","sequence":"additional","affiliation":[{"name":"Initiatives IdEx Globule Rouge d'Excellence (InIdex GR\u2010Ex), Universit\u00e9 Paris Cit\u00e9  Paris France"},{"name":"Aix Marseille Universit\u00e9 CNRS, EFS, ADES  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8348-0430","authenticated-orcid":false,"given":"Geoffrey","family":"Cheminet","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, French Sickle Cell Disease Referral Center AP\u2010HP, H\u00f4pital Europ\u00e9en Georges Pompidou  Paris France"},{"name":"Initiatives IdEx Globule Rouge d'Excellence (InIdex GR\u2010Ex), Universit\u00e9 Paris Cit\u00e9  Paris France"},{"name":"Universit\u00e9 Paris Cit\u00e9, INSERM U1163, Imagine Institute Laboratory \u201cMolecular Mechanisms of Hematological Disorders and Therapeutic Implications\u201d  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2608-302X","authenticated-orcid":false,"given":"Jean\u2010Benoit","family":"Arlet","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, French Sickle Cell Disease Referral Center AP\u2010HP, H\u00f4pital Europ\u00e9en Georges Pompidou  Paris France"},{"name":"Initiatives IdEx Globule Rouge d'Excellence (InIdex GR\u2010Ex), Universit\u00e9 Paris Cit\u00e9  Paris France"},{"name":"Universit\u00e9 Paris Cit\u00e9, INSERM U1163, Imagine Institute Laboratory \u201cMolecular Mechanisms of Hematological Disorders and Therapeutic Implications\u201d  Paris France"},{"name":"Universit\u00e9 Paris Cit\u00e9, Facult\u00e9 de Sant\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"2018","DOI":"10.1016\/S0140-6736(10)61029-X","article-title":"Sickle\u2010Cell Disease","volume":"376","author":"Rees D. 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