Sickle cell disease (SCD) is a common genetic disorder affecting up to 2.6% of the population in Saudi Arabia. SCD results in severe disability, reduced quality of life, extensive use of medical resources, increased economic burden, and a high likelihood of increased mortality. Red blood cell transfusion remains a cornerstone in the management of SCD complications. This position paper highlights the current state of SCD management within the Kingdom of Saudi Arabia. Despite the advantages of automated red blood cell exchange (aRBCX) and guideline recommendations, its use remains limited. In practice, aRBCX is used for a variety of indications, including acute management and prophylaxis of stroke, systemic fat embolism, severe forms of acute chest syndrome, preoperative management, hematopoietic stem cell transplantation, hepatic crisis, and priapism. However, aRBCX is underutilized in pregnancy. Common gaps identified by the advisory panel include the absence of standardized national guidelines, limited access to aRBCX, issues with vascular access, lack of equipment, and insufficient staff training. Another limitation to the use of aRBCX is the higher blood requirements compared to other blood transfusion modalities. These factors contribute to geographical disparities in the management of SCD and suboptimal patient outcomes. To address these issues, the advisory panel recommended developing and implementing evidence-based national guidelines, expanding access to aRBCX, enhancing health staff education and training, and establishing a robust national SCD registry. By prioritizing these recommendations, we can help streamline SCD care, reduce practice variation, and nationalize sickle cell disease management in Saudi Arabia to improve patient care.

BACKGROUND: Gynecological and nutritional factors are key contributors to the development of iron deficiency anemia (IDA) in women. OBJECTIVE: This study was conducted to assess IDA among female university students in Saudi Arabia. DESIGN: Cross-sectional study. SETTING: University. PATIENTS AND METHODS: A total of 1100 female university students and staff were surveyed from August to November 2024. Participants completed questionnaires and had blood samples drawn (5 mL each in ethylenediaminetetraacetic acid and serum separator tube (SST) tubes), which were analyzed for complete blood count, hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, iron, unsaturated iron binding capacity, ferritin, and total iron binding capacity using Beckman Coulter instruments. The data were analyzed using 2025 JMP, v. 18, for descriptive and Chi-square statistics. SAMPLE SIZE: Sample size was 1100 participants. RESULTS: The study included 1081 participants, predominantly aged 18–25 years (95%), Saudi nationals (98%), undergraduates (77%), and single (99%). Iron deficiency was prevalent among the participants (60%), with 20% reporting having anemia. Of the 20% with confirmed anemia, 84.3% were iron-deficient; only 15.7% had normal serum iron levels with different types of anemia. Menstrual patterns varied: 83% reported having regular cycles; 97% having a cycle each month; and 88% normal flow. Menstrual frequency and duration significantly impacted iron status and anemia type ( P < 0.05). Dietary intake significantly iron status, with regular meat consumers showing higher normal iron levels (43%), while green leafy vegetable consumers had higher iron deficiency (59%). CONCLUSIONS: Prompt clinical intervention for conditions such as increased menstrual frequency and prolonged menstrual duration, coupled with the inclusion of iron-rich sources in the diet, particularly meat, is critical for the prevention of IDA. LIMITATIONS: Cross-sectional design.