{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T21:43:32Z","timestamp":1792187012914,"version":"4.4.0"},"reference-count":50,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T00:00:00Z","timestamp":1728950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["P01HL149626"],"award-info":[{"award-number":["P01HL149626"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>With chronic transfusion in sickle cell disease (SCD), equipoise exists regarding whether increasing the post\u2010procedure hematocrit (Hct) suppresses endogenous erythropoiesis. Reticulocytosis predicts SCD morbidity and mortality, so this study's objective was to clarify the role of the post\u2010procedure Hct in suppressing reticulocytosis and to identify other potential red cell exchange (RCE) parameters predictive of reticulocytosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Methods<\/jats:title><jats:p>This retrospective analysis of 17 patients who underwent chronic RCE at a single institution between 2014 and 2022 examined both standard red cell exchanges (SRCE) and exchanges preceded by isovolemic hemodilution (IVH\u2010RCE). Post\u2010procedure parameters with biologic plausibility to influence the subsequent procedure's absolute reticulocyte count (sPre\u2010ARC) were examined using regression modeling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Neither post\u2010hematocrit, nor post\u2010hemoglobin (Hb), nor \u0394Hb\/day was associated with sPre\u2010ARC or the change in HbS% per day (\u0394HbS%\/day). Concurrent Hb was predictive for SRCE but not IVH\u2010RCE, where ARC trended lower than with SRCE. Male gender and post\u2010procedure neutrophil and white cell counts were predictors of sPre\u2010ARC, consistent with their associations with SCD morbidity and mortality. IVH\u2010RCE had a stronger correlation than standard RCE between pre\u2010Hct and neutrophil or white cell depletion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Although targeting a post\u2010procedure Hct maintains a higher subsequent pre\u2010procedure Hb and a lower sPre\u2010HbS%, it does not lead to sustained suppression of reticulocytosis as measured by the sPre\u2010ARC or the \u0394HbS%\/day. IVH\u2010RCE or the addition of hydroxyurea could be considered in those patients with high reticulocyte, white blood cell, or neutrophil counts.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.18044","type":"journal-article","created":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T11:45:42Z","timestamp":1728992742000},"page":"2270-2278","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Post\u2010exchange neutrophil count, but not post\u2010hematocrit, predicts endogenous erythropoiesis in patients with sickle cell disease undergoing chronic red cell exchange"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7807-6046","authenticated-orcid":false,"given":"Nalan","family":"Yurtsever","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Zucker School of Medicine at Hofstra\/Northwell  Hempstead New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5011-1583","authenticated-orcid":false,"given":"Nicholas","family":"Tong","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Zucker School of Medicine at Hofstra\/Northwell  Hempstead New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saroja","family":"Geetha","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Zucker School of Medicine at Hofstra\/Northwell  Hempstead New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Nandi","sequence":"additional","affiliation":[{"name":"Clinical Services New York Blood Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7954-0055","authenticated-orcid":false,"given":"Patricia A.","family":"Shi","sequence":"additional","affiliation":[{"name":"Clinical Services New York Blood Center  New York New York USA"},{"name":"Division of Medical Oncology and Hematology Monter Cancer Center Northwell Health Cancer Institute  New Hyde Park New York 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