Hyperbaric oxygen therapy in a case of combined sickle cell and hemoglobin Lepore disease

*Hematology Division, Department of Oncology, Transplant and New Technologies in Medicine, University of Pisa, Pisa, Italy; † Emergency Department, Hyperbaric Therapy Center, Pisa University Hospital, Pisa, Italy Dear Sir, The management of hemoglobin disorders still represents a major clinical challenge. Sickle cell anemia and related disorders, including sickle cell thalassemia disease, are almost unequivocally complicated by multiorgan damage and characterized by recurrent crises. Therapeutic approaches are not curative and a carefully evaluated transfusion program is frequently necessary, especially in critical situations such as surgery. Conflicting results about the use of hyperbaric oxygen therapy in acute sickle cell crisis have been reported. 1,2 To date, there are no conclusive studies defining the possible benefits of this therapeutic approach. The management of sickle cell anemia essentially involves aspirin administration and the treatment of complications as they arise. Transfusions are not usually required except in special circumstances such as stroke or intractable, frequently recurring, painful crises. Transfusions may be used for the repair of leg ulcers. One very large study, however, found no difference in healing rates associated with any particular therapeutic modality. 3