Varied hemodynamic and metabolic responses of disease modifying and curative therapies in adults with sickle cell disease

Two common treatment paradigms for sickle cell disease (SCD) include oral medication hydroxyurea and blood transfusions. Rarely, a curative hematopoietic stem cell transplant (HSCT) is performed. We utilized non-invasive MRI to evaluate how potential biomarkers of infarct risk, cerebral blood flow (CBF) and oxygen extraction fraction (OEF), change in these treatment paradigms (cumulative n=39). Hydroxyurea treatment did not have significant changes to hemoglobin, CBF, or OEF between two scans. Hemoglobin increases by approximately 8.73 and 64.11% for adults with SCD on transfusion and transplant treatments, respectively. These changes most prominently parallel a reduction in CBF of 20.46 and 31.67%, respectively.