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Blood, 1 January 2007, Vol. 109, No. 1, pp. 40-45. Prepublished online as a Blood First Edition Paper on August 29, 2006; DOI 10.1182/blood-2006-02-005082. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2006-02-005082v1 109/1/40    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Quinn, C. T. Articles by Buchanan, G. R. Search for Related Content PubMed PubMed Citation Articles by Quinn, C. T. Articles by Buchanan, G. R. Related Collections Hemostasis, Thrombosis, and Vascular Biology Red Cells Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Prognostic significance of early vaso-occlusive complications in children with sickle cell anemia Charles T. Quinn1,3,, Elizabeth P. Shull2,3, Naveed Ahmad3, Nancy J. Lee2,3, Zora R. Rogers1,3, and George R. Buchanan1,3 1 Division of Hematology-Oncology, Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, Dallas, TX; 2 Southwestern Comprehensive Sickle Cell Center, Dallas, TX; and 3 Children's Medical Center Dallas, Dallas, TX Sickle cell anemia (SS) is highly phenotypically variable, and early predictors of outcome could guide clinical care. To determine whether early vaso-occlusive complications predicted subsequent adverse outcomes in the Dallas Newborn Cohort, we studied all members with SS or sickle-ß0-thalassemia who presented in their first year of life and had 5 years or more of follow-up. We defined 3 potential early predictors: hospitalizations in the first 3 years of life for (1) painful events other than dactylitis, (2) dactylitis, and (3) acute chest syndrome (ACS). We studied the associations of these predictors with the following late adverse outcomes (occurring after the third birthday): death, first overt stroke, use of disease-modifying therapy, and hospitalizations for pain events and ACS. None of the early events predicted death or stroke. Early pain and ACS both predicted a modest, temporary increase in the number of later painful episodes, but early ACS strongly increased the odds of more frequent ACS throughout childhood. Dactylitis had limited utility as a predictor. Although we still lack a useful prognostic framework for young children with SS, those who experience early ACS might be candidates for higher risk interventions to mitigate or cure their disease. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: A. Hryniewicz-Jankowska, P. K. Choudhary, L. P. Ammann, C. T. Quinn, and S. R. Goodman Monocyte Protein Signatures of Disease Severity in Sickle Cell Anemia Experimental Biology and Medicine, February 1, 2009; 234(2): 210 - 221. [Abstract] [Full Text] [PDF] C. T. Quinn, N. J. Lee, E. P. Shull, N. Ahmad, Z. R. Rogers, and G. R. Buchanan Prediction of adverse outcomes in children with sickle cell anemia: a study of the Dallas Newborn Cohort Blood, January 15, 2008; 111(2): 544 - 548. [Abstract] [Full Text] [PDF]

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