Table 1.

Questions prioritized by the ASH Guideline Panel on Transfusion Support

Prioritized questions
Q1. Should an extended red cell antigen profile be obtained by genotype or serology vs only ABO/RhD type for patients with SCD?
Q2. Should prophylactic Rh (C, E, or C/c, E/e)- and K-matched red cells or prophylactic Rh (C, E or C/c, E/e)-matched, K-matched, and extended matched (Jka/Jkb, Fya/Fyb, S/s) red cells, by serologic or genotype-predicted red cell antigen profile, vs only ABO/RhD-matched red cells be used for patients with SCD receiving transfusions?
Q3. Should immunosuppressive therapy (IVIg, steroids, and/or rituximab) vs no immunosuppressive therapy be used for patients with SCD (all genotypes) with an acute need for transfusion and with a high risk for HTR?
Q4. Should immunosuppressive therapy (IVIg, steroids, rituximab, and/or eculizumab) vs no immunosuppressive therapy be used for patients with SCD (all genotypes) with ongoing hyperhemolysis (defined as rapid decline of posttransfusion hemoglobin to below the pretransfusion level)?
Q5. Should automated RCE vs simple transfusion or manual RCE be used for patients with SCD receiving chronic transfusions?
Q6. Should automated or manual RCE be used over simple transfusion for patients with SCD and severe acute chest syndrome?
Q7. Should red cell exchange with IHD-RCE vs conventional RCE be used for patients with SCD receiving chronic transfusions?
Q8. Should prophylactic transfusion at regular intervals vs standard care (transfusion only when indicated for a complication or exacerbated anemia) be provided to pregnant patients with SCD?
Q9. Should preoperative transfusion vs no preoperative transfusion be used for patients with SCD undergoing surgeries requiring general anesthesia and lasting longer than 1 h?
Q10a. Should iron overload screening by MRI for liver iron content vs serial monitoring of ferritin levels alone be used for patients with SCD receiving chronic transfusion therapy?
Q10b. Should iron overload screening by MRI for cardiac iron content vs serial monitoring of ferritin levels alone be used for patients with SCD receiving chronic transfusion therapy?