Nomogram for the diagnosis of Delayed Hemolytic Transfusion Reaction as proposed by Mekontso Dessap et al, Am J Hematol. 2016 Dec;91(12):1181-1184.



Legend: This nomogram is proposed to estimate the likelihood of Delayed Hemolytic Transfusion Reaction (DHTR) in Sickle Cell Disease patients. To use the nomogram, the relative change in patient’s hemoglobin A (HbA) concentration and the time interval since post-transfusion electrophoresis are plotted. If the resulting point is above and to the right of the upper limit line, DHTR likelihood is low. If the point is below and to the left of the lower limit line, DHTR likelihood is high. If the point is between the two lines, DHTR likelihood is intermediate. Patients withouth a post-transfusion hemoglobin electrophoresis cannot be evaluated with the use of the nomogram. The relative change in HbA concentration is calculated as 100*(HbA concentration at DHTR suspicion – post-transfusion HbA concentration) / post-transfusion HbA concentration ; with HbA concentration expressed in g/dL (percent HbA * total Hb in g/dL).

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