Stroke and conversion to high risk in children screened with transcranial Doppler ultrasound during the STOP study

Robert J. Adams, Donald J. Brambilla, Suzanne Granger, Dianne Gallagher, Elliott Vichinsky, Miguel R. Abboud, Charles H. Pegelow, Gerald Woods, Elizabeth M. Rohde, Fenwick T Nichols, Anne Jones, Judith P. Luden, Latonya Bowman, Susan Hagner, Knashawn H. Morales, E. Steve Roach

Research output: Contribution to journalArticle

122 Citations (Scopus)

Abstract

The Stroke Prevention Trial in Sickle Cell Anemia (STOP) was a randomized multicenter controlled trial comparing prophylactic blood transfusion with standard care in sickle cell anemia (SCA) children aged 2 to 16 years selected for high stroke risk by transcranial Doppler (TCD). More than 2000 children were screened with TCD to identify the 130 high-risk children who entered the randomized trial. A total of 5613 TCD studies from 2324 children were evaluated. We also collected information on stroke. We describe the changes in TCD with repeated testing and report the outcome without transfusion in the STOP screened cohort. Risk of stroke was higher with abnormal TCD than with normal or conditional TCD (P < .001) or inadequate TCD (P = .002), and risk with conditional TCD was higher than with normal TCD (P < .001). Repeated TCD in 1215 children showed that the condition of 9.4% of children became abnormal during observation. Younger patients and those with higher initial flow velocities were most likely to convert to abnormal TCDs. Screening in STOP confirmed the predictive value of TCD for stroke. Substantial differences in the probability of conversion to abnormal TCD were observed, with younger children and those with higher velocity more likely to have an abnormal TCD with rescreening.

Original languageEnglish (US)
Pages (from-to)3689-3694
Number of pages6
JournalBlood
Volume103
Issue number10
DOIs
StatePublished - May 15 2004
Externally publishedYes

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Doppler Ultrasonography
Ultrasonics
Stroke
Sickle Cell Anemia
Flow velocity
Screening
Blood
Blood Transfusion
Testing
Multicenter Studies
Randomized Controlled Trials
Observation

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

Adams, R. J., Brambilla, D. J., Granger, S., Gallagher, D., Vichinsky, E., Abboud, M. R., ... Roach, E. S. (2004). Stroke and conversion to high risk in children screened with transcranial Doppler ultrasound during the STOP study. Blood, 103(10), 3689-3694. https://doi.org/10.1182/blood-2003-08-2733

Stroke and conversion to high risk in children screened with transcranial Doppler ultrasound during the STOP study. / Adams, Robert J.; Brambilla, Donald J.; Granger, Suzanne; Gallagher, Dianne; Vichinsky, Elliott; Abboud, Miguel R.; Pegelow, Charles H.; Woods, Gerald; Rohde, Elizabeth M.; Nichols, Fenwick T; Jones, Anne; Luden, Judith P.; Bowman, Latonya; Hagner, Susan; Morales, Knashawn H.; Roach, E. Steve.

In: Blood, Vol. 103, No. 10, 15.05.2004, p. 3689-3694.

Research output: Contribution to journalArticle

Adams, RJ, Brambilla, DJ, Granger, S, Gallagher, D, Vichinsky, E, Abboud, MR, Pegelow, CH, Woods, G, Rohde, EM, Nichols, FT, Jones, A, Luden, JP, Bowman, L, Hagner, S, Morales, KH & Roach, ES 2004, 'Stroke and conversion to high risk in children screened with transcranial Doppler ultrasound during the STOP study', Blood, vol. 103, no. 10, pp. 3689-3694. https://doi.org/10.1182/blood-2003-08-2733
Adams RJ, Brambilla DJ, Granger S, Gallagher D, Vichinsky E, Abboud MR et al. Stroke and conversion to high risk in children screened with transcranial Doppler ultrasound during the STOP study. Blood. 2004 May 15;103(10):3689-3694. https://doi.org/10.1182/blood-2003-08-2733
Adams, Robert J. ; Brambilla, Donald J. ; Granger, Suzanne ; Gallagher, Dianne ; Vichinsky, Elliott ; Abboud, Miguel R. ; Pegelow, Charles H. ; Woods, Gerald ; Rohde, Elizabeth M. ; Nichols, Fenwick T ; Jones, Anne ; Luden, Judith P. ; Bowman, Latonya ; Hagner, Susan ; Morales, Knashawn H. ; Roach, E. Steve. / Stroke and conversion to high risk in children screened with transcranial Doppler ultrasound during the STOP study. In: Blood. 2004 ; Vol. 103, No. 10. pp. 3689-3694.
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abstract = "The Stroke Prevention Trial in Sickle Cell Anemia (STOP) was a randomized multicenter controlled trial comparing prophylactic blood transfusion with standard care in sickle cell anemia (SCA) children aged 2 to 16 years selected for high stroke risk by transcranial Doppler (TCD). More than 2000 children were screened with TCD to identify the 130 high-risk children who entered the randomized trial. A total of 5613 TCD studies from 2324 children were evaluated. We also collected information on stroke. We describe the changes in TCD with repeated testing and report the outcome without transfusion in the STOP screened cohort. Risk of stroke was higher with abnormal TCD than with normal or conditional TCD (P < .001) or inadequate TCD (P = .002), and risk with conditional TCD was higher than with normal TCD (P < .001). Repeated TCD in 1215 children showed that the condition of 9.4{\%} of children became abnormal during observation. Younger patients and those with higher initial flow velocities were most likely to convert to abnormal TCDs. Screening in STOP confirmed the predictive value of TCD for stroke. Substantial differences in the probability of conversion to abnormal TCD were observed, with younger children and those with higher velocity more likely to have an abnormal TCD with rescreening.",
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