Evidence map›Paper›PMID 29100558›Full record

Observational studyThe Lancet. Haematology2017

Immunohaematological complications in patients with sickle cell disease after haemopoietic progenitor cell transplantation: a prospective, single-centre, observational study.

Elizabeth S Allen, Kshitij Srivastava, Matthew M Hsieh, Courtney D Fitzhugh, Harvey G Klein, John F Tisdale, Willy A Flegel

Open access · greenAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The Lancet. Haematology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed
2.3field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 33 citations in OpenAlex.

  1. Trial
  2. Review
  3. Article
  4. Review
  5. ABO-Mismatch Hematopoietic Stem Cell Transplantation with Pre-existing Red Cell Alloantibody Resembling a Case of Post-transplant Autoimmune Hemolytic Anemia.Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion · 2025
    Article
  6. Article
  7. Review
  8. Review
  9. Alloimmunization and hyperhemolysis in sickle cell disease.Hematology. American Society of Hematology. Education Program · 2023
    Article
  10. Review
  11. Article
  12. Review
  13. Article
  14. Article
  15. Review
  16. Review
  17. Article
  18. Article
  19. Red Cell Transfusions in the Genomics Era.Seminars in hematology · 2019
    Review
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Elizabeth S AllenDepartment of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, MD, USA.
Kshitij SrivastavaDepartment of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, MD, USA.
Matthew M HsiehMolecular and Clinical Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
Courtney D FitzhughSickle Cell Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
Harvey G KleinDepartment of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, MD, USA.
John F TisdaleMolecular and Clinical Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
Willy A FlegelDepartment of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, MD, USA. Electronic address: waf@nih.gov.
National Institutes of Health Clinical Center · USNational Heart Lung and Blood Institute · USNational Institutes of Health · US

Funding

Nonmyeloablative haploidentical peripheral blood stem cell transplantation in congenital anemiasZIAHL006211 · NHLBI · NATIONAL HEART, LUNG, AND BLOOD INSTITUTE · PI FITZHUGH, COURTNEY · 2016 to 2025
$19.4M
Nonmyeloablative allogeneic PBSC in globin disordersZIAHL006007 · NHLBI · NATIONAL HEART, LUNG, AND BLOOD INSTITUTE · PI TISDALE, JOHN · 2009 to 2025
$18.4M
Intramural NIH HHS Z99 CL999999Intramural NIH HHS Z99 HL999999
6 · The paper itself

Abstract

backgroundHaemopoietic progenitor cell (HPC) transplantation can cure sickle cell disease. Non-myeloablative conditioning typically results in donor-derived erythrocytes and stable mixed chimerism of recipient-derived and donor-derived leucocytes. Exposure to donor antigens from the HPC graft and new red cell antibodies induced by transfusion can lead to immunohaematological complications. We assessed the incidence of such complications among HPC transplant recipients with sickle cell disease.

methodsThe study population was all patients with sickle cell disease enrolled before March 31, 2015, in the three clinical trials of non-myeloablative HPC transplantation at the National Institutes of Health. We assessed formation of new red cell antibodies after transplantation and red cell incompatibility between donors and recipients.

findings61 patients were enrolled, 42 were HLA matched and 19 were haploidentical. Nine (15%) had immunohaematological complications. Before HPC transplantation, three patients had antibodies incompatible with their donors. After HPC transplantation, new red cell antibodies were seen in six patients (11 alloantibodies and two autoantibodies), among whom three developed antibodies incompatible with donor or recipient red cells and three developed compatible antibodies. The clinical course of complications was highly variable, from no severe effects attributable to antibodies, to sustained reticulocytopenia, to near-fatal haemolysis. We found no significant correlation between immunohaematological complications and graft failure, graft rejection, or death.

interpretationClinical effects ranged from seemingly not clinically important to potentially fatal. In patients with sickle cell disease, donor and recipient red cell phenotypes should be carefully assessed before transplantation to minimise and manage the risk of immunohaematological complications.

fundingIntramural Research Program and National Institutes of Health.

Indexed as

Anemia, Sickle CellGraft vs Host DiseaseHematopoietic Stem Cell TransplantationAdultFemaleHumansMaleProspective StudiesTransplantation Conditioning

Identifiers

PMID29100558
PMCPMC6311987
OpenAlexW2765386406

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.