Assessment of Coagulation Profiles and Investigation of Leukaemia Incidence in Sickle Cell Patients at Lagos University Teaching Hospital

Aims: The purpose of this research was to assess and compare the coagulation and haematological profiles of sickle cell disease (SCD) patients to those without the condition, as well as to ascertain the incidence of leukaemia in SC patients. It specifically examined if there were any observable variations between SCD patients with and without leg ulcers, as well as variances in coagulation parameters including prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen, and D-Dimer levels.

Study Design: In order to ascertain the incidence of leukaemia and evaluate the coagulation and haematological profiles of sickle cell patients (steady state) with leg ulcers, as well as non-leg ulcer and non-sickle cell persons as the control group, this study used a case control design.

Place and Duration of Study: The study was conducted at the Sickle Cell Foundation Nigeria, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria, from May to September 2024.

Methodology:
A questionnaire was developed and administered to both patients with sickle cell disease (SCD) at their steady state and individuals in the control group (non-SCD). Ninety-two (92) participants were recruited for this study, of which 80 met the inclusion criteria. Fifty (50) subjects were of the SCD case group, while 30 were of the non-SCD control group. The 80 consenting participants comprised 44 males and 36 females. The average age for SCD cases was 19.58 ± 9.8 years, while controls averaged 27.4 ± 12.3 years. Investigations were carried out on all the samples for Full Blood Count, coagulation profile, haemoglobin electrophoresis, ABO blood group, and peripheral blood film examination. Ethical approval was obtained from the College of Medicine, University of Lagos, and the Sickle Cell Foundation, Nigeria. Data were analyzed using t-tests to compare haematological and coagulation parameters between groups. All analyses were performed using R and Python to ensure accurate data analysis, which is crucial in clinical research.

Results: While significant differences were found in haematological parameters between SCD patients and controls—specifically lower red blood cell counts, haematocrit, and haemoglobin levels, alongside elevated white blood cell and platelet counts (P < 0.001)—no new cases of leukemia were detected. Coagulation profiles, including PT and APTT, were prolonged in SCD patients (P < 0.001), though fibrinogen and D-Dimer levels showed no statistically significant differences between SCD and control groups (P = 0.563 and P = 0.223, respectively).

Conclusion: The absence of leukaemia in our sample highlights the potential rarity of leukaemia in this SCD population. The coagulation profile anomalies highlight the therapeutic significance of monitoring thrombotic risks in the management of sickle cell disease (SCD), even if no significant connection with leukaemia was established. Our results shed light on the haemorrhagic problems associated with sickle cell disease (SCD), even when leukaemia is not present. They also imply that vigilant monitoring of coagulation parameters is still very essential to shield SCD patients from vascular complications.