Blood Journal
Leading the way in experimental and clinical research in hematology

Omega-3 fatty acids in sickle cell anemia

  1. Simeon Pollack
  1. Department of Medicine, Albert Einstein College of Medicine, Bronx, NY

To the editor:

A study done a decade ago found that treatment of sickle cell anemia with ω-3 fatty acids reduced the frequency of pain episodes from 7.8 to 3.8 per year (P < .01).1 However, only 10 patients completed that study, and the finding received scant attention. A more recent study of 140 Sudanese patients (including children and adults with ages ranging from 2 to 24 years) found that ω-3 fatty acids reduced the frequency of pain episodes from a median of 4.6 to 2.7 per year (P < .01) and of pain requiring hospitalization from a median of 1 to 0 per year (P < .0001). They also reduced the frequency of severe anemia from 16.4% to 3.2% per year (P < .05) and of transfusion from 16.4% to 4.5% per year (P < .03).2 The theoretical ability of ω-3 fatty acids to ameliorate aspects of the pathophysiology of sickle cell anemia—the coagulopathy,1 the increased red blood cell adhesiveness,2,3 the inflammation,4 and the NO insufficiency5—adds credence to the empiric observations.

However, the subjective nature of judgments regarding pain and the need for hospital care and the phenotypic heterogeneity of sickle cell disease6 are reasons to delay accepting the universality of these studies. A firm recommendation about treatment of the millions of individuals with sickle cell anemia should be supported by a larger multicenter study.

Nevertheless, funding and then organizing and completing the needed study will take years. Thus, clinicians must juxtapose the possibility that a generation of patients with sickle cell anemia might be helped by ω-3 fatty acids (which appear to have negligible toxicity) against the possibility that ω-3 fatty acids might prove to be no better than a placebo in a large, controlled, double-blind multicenter study.

Authorship

Conflict-of-interest disclosure: The author declares no competing financial interests.

Correspondence: Simeon Pollack, 5 Wooddale Ave, Croton on Hudson, NY 10520; e-mail: simeonpollack{at}optonline.net.

References