Prevention of stroke in sickle cell disease

In this issue of Blood, Oluwole et al address the important question of the incidence of stroke in adults as well as in children with sickle cell disease (SCD), using a California database formed from hospital discharge and emergency department information. 1The cumulative incidence of the cerebrovascular events (CVEs) (ischemic and hemorrhagic stroke and transient ischemic attack) appears to have increased in California during the decade from 2010 to 2019 across all age groups, including children and adolescents.This finding is disappointing given the availability since 1998 of transcranial Doppler (TCD) screening and regular transfusion for abnormal TCD velocity >200 cm/s for children with homozygous SCD.This program was initially