Sickle Cell Disease: Treatment Options of the Past, Present, and Future.
Charleen T Jacobs-McFarlane, Angela Liu
PMID 41437446WHAT IT FOUND
Sickle cell care now has more drug and curative options, but nurses should expect barriers: cost, access, frequent monitoring, infusion burden, and uncertain long-term safety.
Key findings
01For vaso-occlusive pain crises, oral or parenteral opioids and nonsteroidal antiinflammatory medications are described as mainstays, and guidelines make no recommendation for or against intravenous fluids because of increased risk of negative cardiopulmonary outcomes.
02Transfusion is not indicated for every vaso-occlusive episode or anemia, and risks include alloimmunization, delayed hemolytic transfusion reactions, and iron overload; iron overload management includes ferritin monitoring, imaging of liver and cardiac iron, and iron chelation.
03Hydroxyurea is first-line for HbSS and HbSβ0 but requires frequent follow-up; bone marrow transplantation and gene therapy are curative options but require myeloablation and have infertility, donor matching, cost, and long-term safety barriers.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It is a narrative review, not a systematic review, so the literature selected and summarized is not described with search or selection methods. It reports no original study methods or results, so its conclusions are syntheses of cited studies and expert statements. Some cited benefits are limited by small samples, excluded genotypes, short follow-up, or uncertain long-term safety. Access, cost, monitoring, and infusion burden are discussed, but the review does not quantify how these barriers affect patient outcomes.
The easy way to misread this
Do not read this review as showing that any treatment works for all people with sickle cell disease. It reports no original study methods or results, and the cited benefits are limited by genotype, small samples, null outcomes, cost, access, and long-term uncertainty.