In two patients with severe painful sickle cell crisis and a deteriorating clinical course, recovery coincided with large-scale exchange transfusions (6 liters). The one patient, with sickle cell beta thalassemia, achieved a 90% exchange, calculated on the sickle cell hemoglobin present before and after transfusion. The other patient, with sickle cell hemoglobin Hb A, S, and (Hb) C disease, also achieved an 80% exchange calculated on the level of HbA.S. AND C in samples before and after transfusion.
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Malcom Green (1975) studied this question.