Transfusion prevents acute chest syndrome predicted by elevated secretory phospholipase A2

Acute pulmonary injury is known as acute chest syndrome (ACS) in patients with sickle cell disease (SCD). Secretory phospholipase A(2) (sPLA(2)) was found to predict those at risk for ACS and a trial was designed to determine if red blood cell transfusion can be used to prevent ACS. Patients with an elevated sPLA(2) were randomised to either receive a single transfusion or standard care. Five of the eight patients (63%) randomised to standard care developed ACS versus none of the seven patients randomised to the transfusion arm (P = 0.026, Odds ratio = 23.6, 95% confidence interval 1, 557). This study suggests that transfusion may prevent ACS.