The existence of hemolysis in sickle cell disease has been documented by both indirect and
direct methods. The existence of bone-marrow erythroid hyperplasia, reticulocytosis, indirect
hyperbilirubinemia, and elevations of plasma hemoglobin and serum lactic acid
dehydrogenase values show hemolytic disease. Direct studies of erythrocyte survival,
including the Ashby differential agglutination technique as well as isotopic methods have all
shown a markedly decreased red blood cell survival in the range of 10 to 30 days mean cell …