{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T07:19:26Z","timestamp":1788506366022,"version":"build-2803163510"},"reference-count":46,"publisher":"American Society of Hematology","issue":"13","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,3,27]]},"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>Globally, an estimated 300 million individuals have sickle cell trait (SCT), the carrier state for sickle cell disease (SCD). Although SCD is associated with increased morbidity and shortened life span, SCT has a life span comparable with that of the general population. However, \u201csickle cell crisis\u201d has been used as a cause of death for decedents with SCT in reports of exertion-related death in athletes, military personnel, and individuals in police custody. To appraise this practice, the American Society of Hematology convened an expert panel of hematologists and forensic pathologists to conduct a systematic review of the literature relating to the occurrence of sickle cell pain crises and exertion-related mortality in people with SCT. Multiple bibliographic databases were searched with controlled vocabulary and keywords related to \u201csickle cell trait,\u201d \u201cvaso-occlusive pain,\u201d and \u201cdeath,\u201d yielding 18 of 1474 citations. Independent pairs of reviewers selected studies and extracted data. We found no studies comparing uncomplicated acute pain crises in individuals with SCT and SCD. Additionally, no study was identified to support the occurrence of acute vaso-occlusive pain crises in individuals with SCT. Furthermore, this systematic review did not identify any evidence to support an association between SCT and sudden unexplained death in the absence of exertion-related rhabdomyolysis. We conclude that there are no data to support the diagnosis of acute vaso-occlusive sickle cell crisis as a cause of death in SCT, nor does the available evidence support the use of SCT as a cause of exertion-related death without rhabdomyolysis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1182\/blood.2024026899","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T09:50:43Z","timestamp":1738230643000},"page":"1345-1352","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":13,"title":["Sickle cell trait does not cause \u201csickle cell crisis\u201d leading to exertion-related death: a systematic review"],"prefix":"10.1182","volume":"145","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8726-6212","authenticated-orcid":false,"given":"Lachelle D.","family":"Weeks","sequence":"first","affiliation":[{"name":"1Department of Medical Oncology, Center for Early Detection and Interception of Blood Cancers and Center for Adult Leukemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6153-3228","authenticated-orcid":false,"given":"Allecia M.","family":"Wilson","sequence":"additional","affiliation":[{"name":"2Department of Pathology, University of Michigan Medical School, Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakhi P.","family":"Naik","sequence":"additional","affiliation":[{"name":"3Division of Hematology, Department of Medicine, Johns Hopkins University, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Efebera","sequence":"additional","affiliation":[{"name":"4Blood and Marrow Transplant and Cellular Therapy, Ohio Health Hematology, Columbus, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Hassan","family":"Murad","sequence":"additional","affiliation":[{"name":"5Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjlee","family":"Mahajan","sequence":"additional","affiliation":[{"name":"6Division of Hematology-Oncology, University of California Davis School of Medicine, Sacramento, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6198-4785","authenticated-orcid":false,"given":"Patrick T.","family":"McGann","sequence":"additional","affiliation":[{"name":"7Department of Pediatric Hematology\/Oncology, Alpert Medical School of Brown University and Hasbro Children\u2019s Hospital, Providence, 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