{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T12:49:36Z","timestamp":1776430176552,"version":"3.51.2"},"reference-count":61,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":106,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"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":["BioMed Research International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Sickle cell disease (SCD) is a genetic disorder characterized by intrinsic clinical manifestations, frequently exacerbated by vaso\u2010occlusive episodes (VOEs), which significantly affect hematological parameters. This systematic review and meta\u2010analysis is aimed at synthesizing evidence from studies published over the past 25 years on complete blood count profiles in SCD patients, both in the steady state and during VOEs. The objective was to clarify hypotheses and highlight the need for prospective studies to establish specific reference values for steady\u2010state SCD patients, thereby improving patient management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      In accordance with the PRISMA guidelines and the Cochrane Handbook, a systematic search of major databases (including PubMed, Web of Science, and Google Scholar) was conducted to identify analytical studies published between 2000 and 2025. Eligible studies compared complete blood count profiles in SCD patients during VOEs and in the steady state. Study selection and data extraction were performed independently by two reviewers, with disagreements resolved by consensus. Extracted data were entered into Microsoft Excel 2013 and analyzed using R statistical software (Version 4.3.2). Between\u2010study heterogeneity was evaluated using Higgins\u2032 inconsistency (\n                      <jats:italic>Q<\/jats:italic>\n                      ) statistics, with results expressed as\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      values and corresponding\n                      <jats:italic>p<\/jats:italic>\n                      values. The risk of bias in the included studies was assessed using the ROBINS\u2010E tool.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eight studies met the inclusion criteria. Pooled analyses demonstrated a significant impact of VOEs on hemogram parameters. This impact was characterized by anemia and erythrocytopenia (standardized mean difference [SMD], random\u2010effects model: \u22120.97 [\u22121.45; \u22120.50]), accompanied by microcytosis (SMD, random\u2010effects model: 0.18 [\u22120.21; 0.58]) and hypochromia (SMD, random\u2010effects model: \u22120.90 [\u22122.96; 1.15]). These changes were also associated with reduced fetal hemoglobin levels, increased red cell distribution width (RDW), and reticulocytosis. Regarding the white blood cell lineage, VOEs were associated with leukocytosis (SMD, random\u2010effects model: 0.73 [0.23; 1.24]) and a moderate increase across leukocyte subpopulations. Concerning the platelet lineage, VOEs exerted variable effects on platelet production, ranging from negative to positive influences, with an overall increase in platelet count (SMDs, random\u2010effects model: \u22120.17 [\u22121.13; 0.78] and 0.78 [0.53; 1.03], respectively), accompanied by reductions in mean platelet volume and platelet distribution width (PDW).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This meta\u2010analysis confirms the substantial influence of VOEs on red blood cell, white blood cell, and platelet parameters, as well as their associated indices. Importantly, although hematological parameters in the steady state are less severely altered than during VOEs, they often remain outside conventional reference ranges, reflecting a distinct physiological baseline in SCD patients. These findings underscore the urgent need for prospective studies to define specific hematological reference values for steady\u2010state SCD patients, which is essential for optimizing their clinical management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/bmri\/2741454","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T11:56:47Z","timestamp":1776427007000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hematological Profile in Sickle Cell Disease: A Systematic Review and Meta\u2010Analysis Comparing Steady\u2010State and Vaso\u2010Occlusive Crisis Phases (2000\u20132025)"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2867-0538","authenticated-orcid":false,"given":"Romaric De Manfouo","family":"Tuono","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0833-8167","authenticated-orcid":false,"given":"Josu\u00e9 Louokdom","family":"Simo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingrid Worti Sulem","family":"Yong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryline Seuko","family":"Njopwouo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2179-3105","authenticated-orcid":false,"given":"Claude Tagny","family":"Tayou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Koki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2020.1758555"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/7501577"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cyto.2014.11.030"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijns4040039"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.70773"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25105427"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019001143"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmolb.2019.00140"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2016.25.240.11118"},{"key":"e_1_2_12_10_2","doi-asserted-by":"publisher","DOI":"10.2147\/JBM.S169872"},{"key":"e_1_2_12_11_2","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/3656717"},{"key":"e_1_2_12_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12288-008-0005-z"},{"key":"e_1_2_12_13_2","doi-asserted-by":"publisher","DOI":"10.14744\/TurkPediatriArs.2019.76301"},{"key":"e_1_2_12_14_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.39008"},{"key":"e_1_2_12_15_2","doi-asserted-by":"publisher","DOI":"10.1159\/000141506"},{"key":"e_1_2_12_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.45.10.902"},{"key":"e_1_2_12_17_2","first-page":"40","article-title":"Haematological Changes Among HIV-Positive Persons on Antiretroviral Therapy at a Tertiary Hospital in Ghana","volume":"37","author":"Obiri-Yeboah D.","year":"2020","journal-title":"West African Journal of Medicine"},{"key":"e_1_2_12_18_2","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2022.43.52.32674"},{"key":"e_1_2_12_19_2","first-page":"30","article-title":"Haematological Profile and Blood Transfusion Pattern of Patients With Sickle Cell Anaemia Vary With Spleen Size","volume":"17","author":"Fasola F. 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