The Effect of Packed Red Blood Cell Transfusion on Complete Blood Count and Hemoglobin Fractions in Adult Patients with Sickle Cell Disease: A Prospective Single-Center Cohort Study in Saudi Arabia

Background: Sickle cell disease (SCD) is a genetic disease where a mutation in beta-globin results in an increased hemoglobin S percentage (Hgb S%), which is responsible for the crisis. The aim of this study was to determine the impact of each unit packed red blood cell (PRBC) simple transfusion on complete blood count (CBC) and high-performance liquid chromatography (HPLC) parameters in adult patients with SCD. Methods: This prospective cohort study was conducted between 29 September 2024, and 30 July 2025, among n = 65 SCD patients requiring hospitalization in the hematology department for blood transfusions. Medication, frequency of admission, and demographic information were obtained from the health informatics system. In addition, CBC, white blood cell (WBC), hemoglobin (Hgb), platelet (Plt), and HPLC data were obtained within 24 h before and after the PRBC transfusion. Results: Of n = 65 SCD patients, 87.7% matched the SS phenotype; 58.5% were females; the mean age was 27.23 years. Blood group O+ accounted for 50.8% of the patients, followed by A+ (33.8%). The mean Hgb values before and after transfusion were 7.16 (standard deviation (SD) 0.82) and 8.67 (SD 0.96), respectively (p < 0.001). The mean Hgb S% values before and after transfusion were 71.25 (SD12.19) and 55.97 (SD11.24), respectively (p < 0.001). The difference in the mean values of WBC, Hgb F% and Hgb A% (p < 0.001), as well as Hgb A2% (p = 0.006), changed significantly before and after blood transfusion. A negative correlation between body mass index (BMI) and changes in Plt count was found (p = 0.009). Conclusions: This study quantified the impact of each PRBC unit on CBC and HPLC parameters. While these findings may support strategies to reduce alloimmunization, this outcome was not evaluated and requires further study.