Dr. Marianne Yee is a pediatric hematologist with clinical research focus in sickle cell disease (SCD) and transfusion medicine. Children and adults with severe complications of SCD may benefit from or even require monthly transfusions of red blood cells (RBC) to prevent disease complications. Chronic transfusion therapy (CTT) provides individuals healthy RBC in their circulation and reduces their body’s production of new sickle cells that can cause disease complications such as stroke. However, despite advances in SCD care, some children and adults continue to have silent or overt strokes despite CTT. The survival of transfused, donor RBC in circulation varies greatly and may impact the success of CTT for individual patients.

In a cohort of over 90 children with SCD receiving CTT who were followed for 1 year, we demonstrated that the estimated survival of each blood transfusion was highly variable and may be influenced by factors relating to both the donor blood units as well as the patient receiving the transfusion. Specifically, patients who have previously made immune responses against transfused RBC (alloimmunization) tended to clear their blood transfusions faster than those who had not had alloimmunization. We also showed that blood transfusion from donors who have a common hematologic condition called glucose-6-phosphate dehydrogenase (G6PD) deficiency did not survive as long in the recipient patients.

Using techniques for precisely measuring the survival of blood transfusions to individuals with SCD, Dr. Yee, in collaboration with Emory's Center for Transfusion and Cellular Therapies (CTCT) aims to understand that factors that will contribute to successful blood transfusion therapy for people with SCD.

Niss O, Lane A, Asnani MR, Yee ME, Raj A, Creary S, Fitzhugh C, Bodas P, Saraf SL, Sarnaik S, Devarajan P, Malik P. Progression of albuminuria in patients with sickle cell anemia: a multicenter, longitudinal study. Blood Advances. 2020 Apr 14; 4(7):1501-1511. PMID: 32289161.

Arthur CA, Chonat S, Fasano R, Yee MEM, Josephson CD, Roback JD, Stowell SR. Examining the Role of Complement in Predicting, Preventing, and Treating Hemolytic Transfusion Reactions. Transfusion Medicine Reviews. 2019 Oct;33(4):217-224. PMID: 31679762.

Yee MEM, Meyer EK, Fasano RM, Lane PA, Josephson CD, Brega AG. Health Literacy and Knowledge of Chronic Transfusion Therapy in Adolescents with Sickle Cell Disease and Caregivers. Pediatric Blood and Cancer. 66(7):e27733 Jul 2019.

Chonat S, Arthur CM, Zerra PE, Maier CL, Jajosky RP, Yee MEM, Miller MJ, Josephson CD, Roback JD, Fasano R, Stowell SR. Challenges in preventing and treating hemolytic complications associated with red blood cell transfusion. Transfus Clin Biol. 2019 May;26(2):130-134

Yee MEM, Josephson CD, Winkler AM, Webb J, Luban NLC, Leong T, Stowell SR, Roback JD, Fasano RM. Hemoglobin A Clearance in Children with Sickle Cell Anemia on Chronic Transfusion Therapy. Transfusion. 2018 Jun;58(6):1363-1371.  

Sagiv E, Fasano RM, Luban NLC, Josephson CD, Stowell SR, Roback JD, Francis RO, Yee MEM. Glucose-6-Phosphate-Dehydrogenase Deficient Red Blood Cell Units are Associated with Decreased Post-Transfusion Red Blood Cell Survival in Children with Sickle Cell Disease. American Journal of Hematology. 2018 May;93(5):630-634.

Yee MEM, Josephson CD, Winkler AM, Webb J, Luban NLC, Leong T, Stowell SR, Fasano RM. Red Blood Cell Minor Antigen Mismatches during Chronic Transfusion Therapy for Sickle Cell Anemia. Transfusion. 2017 Nov;57(11):2738-2746. 


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NCI/NHLBI: K23HL146904 – 04/01/2020-03/21/2025

Kinetics of Red Blood Cell Clearance in Chronically Transfused Children with Sickle Cell Disease

Role: PI