The predictiveness curve could help determine the risk of vaso-occlusive crisis in children with sickle cell disease (SCD) and allow clinicians to choose the appropriate preventive treatments, according to a new study published in The Turkish Journal of Pediatrics.

It is of great importance to have a selection of biomarkers that includes information about the risk of disease to improve SCD treatment. The strength of the predictiveness curve is that it provides disease risk information by comparing more than 1 biomarker.

In the present study, a team of researchers led by Veysi Akbey, MD, from Mersin Su Hospital in Turkey used the predictiveness curve for the first time, which classifies patients according to low- and high-risk thresholds, to evaluate the risk of vaso-occlusive crisis in SCD.

“Our aim was to define this new statistical method and to determine the biomarkers that predict vaso-occlusive crisis,” they wrote.

Read more about the treatment of SCD

They included 38 children with SCD in the study. They analyzed and compared levels of C-reactive protein, interleukin-6 (IL-6), tumor necrosis factor (TNF-α), and YKL-40 as well as white blood cells in patients with and without vaso-occlusive crisis. Then using the predictiveness curve, they assessed patients with a low or high risk of vaso-occlusive crisis.

They reported that based on the predictiveness curve, TNF-α, IL-6, and white blood cells could help detect patients who are at high risk of vaso-occlusive crisis. Moreover, “TNF-α was the best risk prediction marker,” they said.

A vaso-occlusive crisis is an episode of extreme pain due to the blockade of capillaries by the sickle-shaped erythrocytes leading to inflammation. Some patients experience as many as a dozen vaso-occlusive crises a year, which may require a hospital stay in most severe cases.

Reference

Şengül MT, Taşdelen B, Ünal S, Akbey V. A feasibility study of risk prediction modelling for vasoocclusive crisis in children with sickle cell disease. Turk J Pediatr. 2022;64:2. doi:10.24953/turkjped.2021.1644