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The key pathogenic flaw lies in mutant haemoglobin S, prone to polymerization under low oxygen conditions, causing erythrocytes to adopt a sickled shape. This leads to complications like vascular occlusion, haemolytic anaemia, inflammation and organ damage. Beyond erythrocyte abnormalities however, there is a body of literature highlighting the hypercoagulable state that is likely a contributor to many of the complications we see in SCD. The persistent activation of the coagulation cascade results in thromboembolic events, notably venous thromboembolism (VTE) which is independently associated with increased mortality in both adults and children with SCD. While the increased risk of VTE in the SCD population seems well established, there is a lack of guidelines for thromboprophylaxis in this population. This Wider Perspective will describe the hypercoagulable state and increased thrombosis risk in the SCD population, as well as advocate for the development of evidence\u2010based guidelines to aid in the prevention of VTE in SCD.<\/jats:p>","DOI":"10.1111\/bjh.19428","type":"journal-article","created":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T09:49:09Z","timestamp":1712310549000},"page":"2184-2193","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluating thromboprophylaxis in the sickle cell disease population: Navigating the evidence gap"],"prefix":"10.1111","volume":"204","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2373-1952","authenticated-orcid":false,"given":"Jennifer","family":"Davila","sequence":"first","affiliation":[{"name":"Division of Pediatric Hematology\u2010Oncology, Department of Pediatrics Albert Einstein College of Medicine, Children's Hospital at Montefiore  Bronx New York 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