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. 2025 Sep 3;17(5):45.
doi: 10.3390/hematolrep17050045.

Interplay Between Sickle Cell Disease and Thrombosis: A Single Center Experience of Pathophysiology and Potential Risk Factors

Rafail Tzanninis  1 , Efthymia Vlachaki  2 , Eleftheria Lefkou  3 , Stavroula Tsiara  4 , Stamatia Theodoridou  5 , Athanasios Vyzantiadis  5 , Miltiadis Matsagkas  1
Affiliations

Interplay Between Sickle Cell Disease and Thrombosis: A Single Center Experience of Pathophysiology and Potential Risk Factors

Rafail Tzanninis et al. Hematol Rep. .

Abstract

Background: Sickle cell disease (SCD) is among the most prevalent inherited hemoglobinopathies and is strongly associated with numerous coagulation abnormalities, hence constituting a severe hypercoagulable state. Methods: We conducted a single-center retrospective observational study of patients with SCD who were monitored at Hippokration Hospital of Thessaloniki between 1999 and 2024. Demographic characteristics, hemoglobin (Hb) genotype, medical history, anticoagulant and antiplatelet therapy, dosage of anticoagulant treatment, recurrence of the first episode of venous thromboembolism (VTE) and relevant laboratory values were examined as possible risk factors. Results: Among 46 patients, 12 (26.1%) developed thrombosis with the majority (75%) carrying the HbS/β-thal genotype. The prevalence of VTE in this study was 17.4%. Variables significantly associated with an increased risk of thrombosis included age at the time of thrombosis, patient age, use of anticoagulant treatment, anticoagulant dosage, antiplatelet therapy and type of transfusion (p < 0.05). On multivariate analysis, anticoagulant treatment and its dosage retained statistical significance (p < 0.05). Conclusions: These findings reinforce the strong association between SCD and thrombotic events. Despite the availability of a broad therapeutic armamentarium and increasing knowledge of the underlying disease mechanisms, the prevention and management of thrombosis in these patients remains a challenge.

Keywords: sickle cell disease; thrombosis; venous thromboembolism.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of patient inclusion in the study.
Figure 2
Figure 2
Anatomic classification of the first thrombotic episode.
Figure 3
Figure 3
Detailed classification of all VOEs.
See this image and copyright information in PMC

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