BLOOD-TRANSFUSIONS AND IMMUNOPHENOTYPIC ALTERATIONS OF LYMPHOCYTE SUBSETS IN SICKLE-CELL-ANEMIA

Transfusions purportedly induce dysfunction of cell-mediated immunity in sickle cell anemia (SCA). We studied hematologic and lymphocytic in dices in 173 human immunodeficiency virus (HIV)-negative subjects with SCA and 131 black controls. Children aged 1 to 7 years with SCA had l eukocyte counts and percentages of granulocytes, monocytes, natural ki ller cells, and T-cell markers (CD2(+)CD11b(+), CD4(+)CD26(+), CD4(+)C D29(+)) that were significantly higher than those for control children . Percent total lymphocytes was decreased for this age group, but the total number of lymphocytes and T and B cell counts were similar to co ntrols. Platelets were not increased. Adolescents (aged 8 to 17 years) and adults (aged greater than or equal to 18 years) with SCA had incr eased total leukocytes and monocytes and lymphocytes counts that remai ned level instead of decreasing, as did comparably aged controls. Lymp hocyte subsets typically increased in count, but their percentage rema ined similar to children. The exception was CD56(+) cell counts, which were increased in adolescents and adults. No lymphocytic subset chang e suggested impaired cellular immunity, and none could be related to t ransfusion. Prophylactically transfused patients had higher granulocyt e counts, but these may arise from the complications of SCA itself. (C ) 1995 by The American Society of Hematology.