The study provides key advice for prenatal care, including when to administer prophylactic medicines and conditions under which healthcare professionals should consider simple blood transfusions or automated red blood cell exchanges (aRBCx).
Researchers from the U.S, Europe and Turkey used iterative Delphi methodology to develop guidance for therapeutic interventions that they hope will optimize the treatment of these high-risk patients.
Sickle cell is a rare blood disorder, with patients often struggling to receive treatment to prevent or decrease the severity of excruciating pain episodes.
During pregnancy, the condition increases a range of risks for both mother and fetus, while decreasing potential therapeutic options due to concerns about teratogenicity. Despite the danger, clinical data on treating this population is scarce.
“This study represents an international collaboration to advance the paradigm of care for women living with sickle cell disease,” said Deva Sharma, assistant professor of hematology-oncology and transfusion medicine at Vanderbilt University Medical Center.
“The expert panelists for this study, in multiple different time zones and corners of the world, worked genuinely with the unified goal of accelerating improvements in the management of this understudied group of women.”
The panel achieved strong consensus on recommendations for monthly obstetrics, gynecology and hematology visits, as well as the routine use of prophylactic aspirin during the second and third trimester to prevent preeclampsia.
In addition, the research clarified the situations when patients are most likely to benefit from prophylactic blood transfusions or aRBCx, a process through which sickled red blood cells are removed using apheresis and replaced with donor cells.
“Publication of the Delphi panel’s recommendations marks an important next step in improving maternal health in sickle cell disease,” said Koenraad Dierick, vice president, patient access at Terumo BCT.
“Our support for this work reflects our broad commitment to patients with sickle cell, which extends to other research, international partnerships, and of course treatment itself. Terumo BCT technology underpins the development and deployment of cutting-edge sickle cell gene therapies, and our Spectra Optia system itself is increasingly used for aRBCx to treat SCD complications.”
Moving forward, the recommendations could be used as a guide for healthcare professionals treating pregnant women with sickle cell.
However, the company notes that guidance may need to be adapted to each location, as sickle cell treatment in higher-income countries mat result in better access to disease-modifying therapies.