{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T10:46:29Z","timestamp":1788345989649,"version":"build-2803163510"},"reference-count":41,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,4,17]],"date-time":"2018-04-17T00:00:00Z","timestamp":1523923200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U58 DD001138"],"award-info":[{"award-number":["U58 DD001138"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["UL1 TR000424"],"award-info":[{"award-number":["UL1 TR000424"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Chronic transfusion therapy for sickle cell anemia reduces disease complications by diluting sickle\u2010erythrocytes with hemoglobin A (HbA)\u2010containing erythrocytes and suppressing erythropoiesis. Minor antigen mismatches may result in alloimmunization, but it is unknown if antigen mismatches or recipient characteristics influence HbA clearance posttransfusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN AND METHODS<\/jats:title><jats:p>Children with sickle cell anemia on chronic transfusion therapy were followed prospectively for 12 months. All patients received units serologically matched for C\/c, E\/e, and K; patients with prior red blood cell (RBC) antibodies had additional matching for Fy<jats:sup>a<\/jats:sup>, Jk<jats:sup>b<\/jats:sup>, and any previous alloantibodies. Patients' RBC antigen genotypes, determined by multiplexed molecular assays (PreciseType Human Erythrocyte Antigen, and RHCE and RHD BeadChip, Immucor) were compared to genotypes of transfused RBC units to assess for antigen mismatches. Decline in hbA (\u0394HbA) from posttransfusion to the next transfusion was calculated for each transfusion episode.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Sixty patients received 789 transfusions, 740 with \u0394HbA estimations, and 630 with donor Human Erythrocyte Antigen genotyping. In univariate mixed\u2010model analysis, \u0394HbA was higher in patients with past RBC antibodies or splenomegaly and lower in patients with splenectomy. RBC antigen mismatches were not associated with \u0394HbA. In multivariate linear mixed\u2010effects modeling, \u0394HbA was associated with RBC antibodies (2.70 vs. 2.45 g\/dL\/28 d, p\u2009=\u20090.0028), splenomegaly (2.87 vs. 2.28 g\/dL\/28 d, p\u2009=\u20090.019), and negatively associated with splenectomy (2.46 vs. 2.70 g\/dL\/28 d, p\u2009=\u20090.011).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>HbA decline was increased among patients with sickle cell anemia with prior immunologic response to RBC antigens and decreased among those with prior splenectomy, demonstrating that recipient immunologic characteristics influenced the clearance of transfused RBCs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.14610","type":"journal-article","created":{"date-parts":[[2018,4,17]],"date-time":"2018-04-17T11:43:58Z","timestamp":1523965438000},"page":"1363-1371","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Hemoglobin A clearance in children with sickle cell anemia on chronic transfusion therapy"],"prefix":"10.1111","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6082-8385","authenticated-orcid":false,"given":"Marianne E. M.","family":"Yee","sequence":"first","affiliation":[{"name":"Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Department of Pediatrics and Hematology\/Oncology Emory University School of Medicine and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassandra D.","family":"Josephson","sequence":"additional","affiliation":[{"name":"Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Department of Pediatrics and Hematology\/Oncology Emory University School of Medicine and the"},{"name":"Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine Emory University School of Medicine Atlanta Georgia; the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M.","family":"Winkler","sequence":"additional","affiliation":[{"name":"Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine Emory University School of Medicine Atlanta Georgia; the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Webb","sequence":"additional","affiliation":[{"name":"Center for Cancer and Blood Disorders, Children's National Medical Center, Departments of Hematology and Laboratory Medicine George Washington University School of Medicine and Health Sciences Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi L.C.","family":"Luban","sequence":"additional","affiliation":[{"name":"Center for Cancer and Blood Disorders, Children's National Medical Center, Departments of Hematology and Laboratory Medicine George Washington University School of Medicine and Health Sciences Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Traci","family":"Leong","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics Emory University, Rollins School of Public Health Atlanta 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