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44 While there was no clear evidence of withdrawal hemolysis associated with the VOCs occurring during the clinical trials in SCD, a sudden stop in drug dosing due to noncompliance or side effects could theoretically translate into an abrupt increase in 2,3-DPG levels and a consequent shift of the oxygen dissociation curve to the right, promoting an acute increase in deoxy-HbS polymerization, sickling, and vaso-occlusion