Background: Sickle cell disease (SCD) is among the most prevalent inherited hemoglobinopathies and is strongly associated with numerous coagulation abnormalities, hence constituting a severe hypercoagulable state. Methods: We conducted a single-center retrospective observational study of patients with SCD who were monitored at Hippokration Hospital of Thessaloniki between 1999 and 2024. Demographic characteristics, hemoglobin (Hb) genotype, medical history, anticoagulant and antiplatelet therapy, dosage of anticoagulant treatment, recurrence of the first episode of venous thromboembolism (VTE) and relevant laboratory values were examined as possible risk factors. Results: Among 46 patients, 12 (26.1%) developed thrombosis with the majority (75%) carrying the HbS/β-thal genotype. The prevalence of VTE in this study was 17.4%. Variables significantly associated with an increased risk of thrombosis included age at the time of thrombosis, patient age, use of anticoagulant treatment, anticoagulant dosage, antiplatelet therapy and type of transfusion (p < 0.05). On multivariate analysis, anticoagulant treatment and its dosage retained statistical significance (p < 0.05). Conclusions: These findings reinforce the strong association between SCD and thrombotic events. Despite the availability of a broad therapeutic armamentarium and increasing knowledge of the underlying disease mechanisms, the prevention and management of thrombosis in these patients remains a challenge.

Sickle Cell Disease (SCD) is one of the most widespread inherited hemoglobinopathies that has been associated with numerous coagulation disorders, hence characterized as a severe hypercoagulable state. We conducted a single-center retrospective observational study of patients with SCD who were monitored at Hippokration Hospital of Thessaloniki between 1999 and 2024. In this study group, demographic data, hemoglobin (Hb) genotype, medical history, use of anticoagulant and antiplatelet treatment, dosage of anticoagulant treatment, recurrence of the first venous thromboembolism (VTE) and laboratory values were examined as possible provoking factors. Twelve patients (12/46-26,1%) developed thrombosis (75% with genotype HbS/β-thal). The prevalence of VTE in this group was 17,4%. Age of thrombosis, age of the patients, anticoagulant treatment, anticoagualants’ dosage, antiplatelet treatment and type of transfusion were significantly associated with increased risk of thrombosis (p<0.05). On multivariate analysis, the anticoagulant treatment and its dosage showed statistical significance (p<0.05).Sickle cell disease and thrombosis are strongly associated. Despite current arsenal of drugs and the broad knowledge related to each one, reducing thrombosis’ occurrence remains a challenge.