Cert Clin Haematology(SA) Paed Practice Questions - CMSA Sub-specialty Certificate In Clinical Haematology (Paediatrics) Exam

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Annual Transcranial Doppler (TCD) screening in a 5-year-old girl with sickle cell anaemia demonstrates a time-averaged maximum mean velocity (TAMMV) of 215 cm/s in the right middle cerebral artery. According to international guidelines (STOP trial criteria), what is the most appropriate long-term management strategy?

Initiation of a regular chronic blood transfusion program to maintain HbS < 30% Discontinuation of hydroxyurea and initiation of low-dose aspirin monotherapy Repeat TCD ultrasonography in 6 months without changing therapy Immediate surgical revascularization (encephaloduroarteriosynangiosis / EDAS)

Correct Answer:

Initiation of a regular chronic blood transfusion program to maintain HbS < 30%

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