Table 1. The guidelines of the American... | American Society of Hematology

Table 1.

The guidelines of the American Society of Hematology (ASH) discussed in this review

	Recommendations or suggestions of ASH	Grading of recommendations	Remarks
Questions 3 and 4: Use of immunosuppressive therapy²⁰	ASH SUGGESTS: Immunosuppressive therapy over no immunosuppressive therapy for high risk of acute hemolytic transfusion reaction or severe history of DHTR	Conditional recommendation based on very low certainty in the evidence about effects	Share decision-making process is critical to weigh the potential benefits and harms associated with transfusion versus the effect of ongoing SC symptoms
	ASH SUGGESTS: Immunosupressive therapy over no immunosuppressive therapy in patients with DHTR and ongoing hyperhemolysis	Conditional recommendation based on very low certainty in the evidence about effects	Share decision-making process Immunotherapy should be initiated promptly if ongoing hyperhemolysis with: - First line: IVIG and high dose steroids - Second line: Eculizumab - Rituximab only to prevent additional antibodies Precipitation of VOC with steroids should be considered

	Recommendations or suggestions of ASH	Grading of recommendations	Remarks
Questions 3 and 4: Use of immunosuppressive therapy²⁰	ASH SUGGESTS: Immunosuppressive therapy over no immunosuppressive therapy for high risk of acute hemolytic transfusion reaction or severe history of DHTR	Conditional recommendation based on very low certainty in the evidence about effects	Share decision-making process is critical to weigh the potential benefits and harms associated with transfusion versus the effect of ongoing SC symptoms
	ASH SUGGESTS: Immunosupressive therapy over no immunosuppressive therapy in patients with DHTR and ongoing hyperhemolysis	Conditional recommendation based on very low certainty in the evidence about effects	Share decision-making process Immunotherapy should be initiated promptly if ongoing hyperhemolysis with: - First line: IVIG and high dose steroids - Second line: Eculizumab - Rituximab only to prevent additional antibodies Precipitation of VOC with steroids should be considered

DHTR, delayed hemolytic transfusion reaction; IVIG, intra veinous immunoglobulin; SC, sickle cell; VOC, vaso-occlusive crisis.