New Advancements in Sickle Cell Care at New York Methodist Hospital

May 20, 2009

Doctors and nurse looking at ultrasound results

From left (standing) Manoj Chabbra, MD, chief of pediatric cardiology, Herold Duroseau, MD, attending physician in pediatrics, Rita Bellevue, program director of NYM's Sickle Cell/Thalassemia Program. Seated, Xiaoyang Zhang, pediatric ultrasound coordinator.

Sickle Cell Disease is an inherited blood disease characterized by the presence of hemoglobin S in the red blood cells. The sickle and rigid shaped red blood cells have difficulty passing through small blood vessels and tend to block the flow of blood; resulting in severe pain and progressive organ damage. The disease most often affects people of African, Hispanic, Caribbean, Indian, Mediterranean and Arabic descent. Approximately two million Americans and one in twelve African-Americans carry the sickle cell trait.

Stroke is one of the more serious complications associated with sickle cell disease. It occurs in approximately 11 percent of patients younger than 20 years old. In fact, children with sickle cell have a 300 percent higher chance of having a stroke than children without the disease. In recent years, a major advancement in sickle cell care occurred with the Stroke Prevention Trial in Sickle Cell Anemia (STOP). The trial not only confirmed the ability of transcranial Doppler (TCD) screenings to prospectively identify children at high risk of stroke, but also demonstrated that regular blood transfusions reduced the risk of stroke in children with the disease, stressed Herold Duroseau, M.D., pediatric hematologist at NYM.

New York Methodist Hospitals (NYM) Comprehensive Sickle Cell/Thalassemia Program, in conjunction with the Hospitals Division of Pediatric Cardiology is now using transcranial Doppler screenings to evaluate the risk of stroke in children (ages two to 16) with the disease. This is a major breakthrough in preventing stroke, said Rita Bellevue M.D., program director of NYMs Sickle Cell/Thalassemia Program. It is a turning point in the treatment of the disease. Children with sickle cell disease should receive a TCD screening once a year

TCD screening uses sound waves to measure the velocity of blood flow through the brains blood vessels; thus it can detect the narrowing of major arteries, which may cause a stroke. The sound waves are overlaid on the image of the blood vessels, creating graphs that show the speed and direction of the blood flow. The procedure is non-invasive, painless, convenient and fast, said Manoj Chabbra, M.D., chief of pediatric cardiology at NYM. The exam takes between 20 and 45 minutes. If the screening reads as abnormal or at high risk for stroke, it is recommended that a transfusion be considered.

The Hospitals Sickle Cell/Thalassemia Program is unique as it provides comprehensive health care and treatment for pediatric, adolescent and adult patients. NYMs expert staff is prepared to handle the disease at every stage of a persons life. For more information, or for an appointment, please contact the Hospitals Sickle Cell/Thalassemia Program (located at 512 Fifth Street) at 718 857-5643 or the Division of Pediatric Cardiology at 718 780-3851.