Trial reportBritish journal of haematology2016
Organ iron accumulation in chronically transfused children with sickle cell anaemia: baseline results from the TWiTCH trial.
Trial report in British journal of haematology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 8 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 8 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Deferasirox versus deferoxamine in managing iron overload in patients with Sickle Cell Anaemia: a systematic review and meta-analysis.The Journal of international medical research · 2022Pooled it
- Hydroxyurea (hydroxycarbamide) for sickle cell disease.The Cochrane database of systematic reviews · 2022Pooled it
- Blood transfusion for preventing primary and secondary stroke in people with sickle cell disease.The Cochrane database of systematic reviews · 2020Pooled it
- Interventions for preventing silent cerebral infarcts in people with sickle cell disease.The Cochrane database of systematic reviews · 2020Pooled it
- Interventions for preventing silent cerebral infarcts in people with sickle cell disease.The Cochrane database of systematic reviews · 2017Pooled it
- Hydroxyurea (hydroxycarbamide) for sickle cell disease.The Cochrane database of systematic reviews · 2017Pooled it
- Blood transfusion for preventing primary and secondary stroke in people with sickle cell disease.The Cochrane database of systematic reviews · 2017Pooled it
- Blood transfusion for preventing primary and secondary stroke in people with sickle cell disease.The Cochrane database of systematic reviews · 2013Pooled it
- Impact of renal iron overload on sickle cell nephropathy in a humanized mouse model.American journal of physiology. Renal physiology · 2026Article
- Evaluating the diagnostic significance of the R2* value on 3.0T MRI for assessing the severity of warm hepatic ischemia-reperfusion injury.BMC gastroenterology · 2025Article
- Initiation of Progressive Morphological Transition Towards an Echino-Stomato-Spherocytic Phenotype by Phosphatidylserine Externalization and Its Implication in Thrombosis.International journal of molecular sciences · 2025Article
- Vamifeport: Monography of the First Oral Ferroportin Inhibitor.Journal of clinical medicine · 2024Review
- Review
- Effects of Iron-Peptides Chelate Nanoliposomes on Iron Supplementation in Rats.Biological trace element research · 2023Article
- Role of Iron Accumulation in Osteoporosis and the Underlying Mechanisms.Current medical science · 2023Article
- Review
- Adverse events of red blood cell transfusions in patients with sickle cell disease.Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis · 2022Review
- Frequency, pattern, and associations of renal iron accumulation in sickle/β-thalassemia patients.Annals of hematology · 2022Article
- Endothelin A receptor antagonist attenuated renal iron accumulation in iron overload heme oxygenase-1 knockout mice.Canadian journal of physiology and pharmacology · 2022Article
- Effects of BJournal of magnetic resonance imaging : JMRI · 2022Article
Corrections and comments
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Authors and funding
12 authors at 9 institutions in 1 country.
Funding
Abstract
Transcranial Doppler (TCD) With Transfusions Changing to Hydroxyurea (TWiTCH) trial is a randomized, open-label comparison of hydroxycarbamide (also termed hydroxyurea) versus continued chronic transfusion therapy for primary stroke prevention in patients with sickle cell anaemia (SCA) and abnormal TCD. Severity and location of iron overload is an important secondary outcome measure. We report the baseline findings of abdominal organ iron burden in 121 participants. At enrollment, patients were young (9·8 ± 2·9 years), predominantly female (60:40), and previously treated with transfusions (4·1 ± 2·4 years) and iron chelation (3·1 ± 2·1 years). Liver iron concentration (LIC; 9·0 ± 6·6 mg/g dry weight) and serum ferritin were moderately elevated (2696 ± 1678 μg/l), but transferrin was incompletely saturated (47·2 ± 23·6%). Spleen R2* was 509 ± 399 Hz (splenic iron ~13·9 mg/g) and correlated with LIC (r(2) = 0·14, P = 0·0008). Pancreas R2* was increased in 38·3% of patients but not to levels associated with endocrine toxicity. Kidney R2* was increased in 80·7% of patients; renal iron correlated with markers of intravascular haemolysis and was elevated in patients with increased urine albumin-creatinine ratios. Extra-hepatic iron deposition is common among children with SCA who receive chronic transfusions, and could potentiate oxidative stress caused by reperfusion injury and decellularized haemoglobin.
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