How can sickle cell crises be prevented?

• A. Avoid dehydration and extreme temperatures
• B. Increase iron intake
• C. Frequent blood transfusions
• D. Daily aspirin

Answer: (C)

The key idea is reducing the amount of sickle hemoglobin in the blood to prevent red cells from sickling and causing vaso-occlusion. Frequent blood transfusions accomplish this by adding normal hemoglobin (HbA) from donor blood, which lowers the percentage of sickle hemoglobin (HbS) in circulating red cells. With fewer HbS-containing cells, the blood is less prone to polymerization and blockage, so crises occur less often. This approach is especially used for patients with recurrent crises or high risk of stroke, making it a direct preventive strategy.

Others focus on avoiding triggers or general support rather than lowering HbS levels: staying hydrated and avoiding extreme temperatures helps reduce risk but isn’t as reliably preventive across all patients; increasing iron intake doesn’t prevent crises; daily aspirin is not a standard preventive measure for vaso-occlusive crises. Note that chronic transfusions have risks, such as iron overload and alloimmunization, so they’re used in specific situations.