Overview

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.