Laboratory values of patient reported in clinical case before and after aRCE. Pretransfusion and posttransfusion hemoglobin (Hb) and hemoglobin S (HbS) are shown on the left axis with units g/dL and percent, respectively. Units for ferritin shown on right axis with units ng/mL. A double lumen port was placed in July 2020, and patient started aRCE in August 2020 using 6  U for each aRCE. Note prior to this, posttransfusion hemoglobin shown in red was typically 11-12  g/dL. Over the next year on aRCE, his posthemoglobin level was closer to his pretransfusion hemoglobin level, typically 10  g/dL. On aRCE, his pretransfusion HbS level decreased and was ultimately maintained closer to his target 30%. His ferritin steadily declined, and he was able to stop chelation medication within 9 months.