{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T23:32:37Z","timestamp":1791415957510,"version":"4.3.3"},"reference-count":52,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,7,8]],"date-time":"2018-07-08T00:00:00Z","timestamp":1531008000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>The desire for pregnancy in sickle cell disease (SCD) women has become a true challenge for hematologists, requiring a multidisciplinary approach. Erythrocytapheresis (ECP) is an important therapeutic tool in SCD, but only limited data on starting time and the effects of ECP during pregnancy are available.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN AND METHODS<\/jats:title><jats:p>This is a double\u2010center retrospective cross\u2010sectional study on a total of 46 single pregnancies in SCD women from January 2008 to June 2017. ECP was started at 10.7\u2009\u00b1\u20095.2 weeks of gestation, and prophylactic enoxaparin (4,000 U daily) was introduced due to the reported high prevalence of thromboembolic events in pregnant SCD women.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The alloimmunization ratio was 2.1 per 1,000 and the alloimmunization rate was 5.6%. In early ECP\u2010treated SCD women, no severe vaso\u2010occlusive crisis, sepsis or severe infection, or preeclampsia or eclampsia were observed. We found normal umbilical arterial impedance during pregnancy, suggesting an optimal uteroplacental function in early ECP\u2013treated SCD women. This was also supported by the improvement in newborn birthweights compared to previous studies. In our cohort, three SCD women were started later on ECP (20\u201025 weeks), and gestation ended with late fetal loss. Placenta pathology documented SCD\u2010related damage and erythroblasts in placental vessels, indicating fetal hypoxia.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Collectively, our data generate a rationale to support a larger clinical trial of early ECP program in SCD pregnancy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.14767","type":"journal-article","created":{"date-parts":[[2018,7,9]],"date-time":"2018-07-09T06:15:09Z","timestamp":1531116909000},"page":"2192-2201","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Improvement of maternal and fetal outcomes in women with sickle cell disease treated with early prophylactic erythrocytapheresis"],"prefix":"10.1111","volume":"58","author":[{"given":"Alice","family":"Vianello","sequence":"first","affiliation":[{"name":"Department of Medicine University of Verona and AOUI\u2010Verona, Policlinico GB Rossi Verona 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