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Author Notes:

Address correspondence to Lakshmanan Krishnamurti, MD, Department of Pediatric Hematology-Oncology-Bone Marrow Transplant, Aflac Cancer and Blood Disorders Center, Emory University School of Medicine, 2015 Uppergate Drive, Suite 400, Atlanta, GA 30322. Tel: (404) 785-0914. Email: lkrishn@emory.edu

The authors have no financial or proprietary interest in the subject matter of this article.

This article meets the Accreditation Council for Graduate Medical Education and the American Board of Medical Specialties Maintenance of Certification competencies for Patient Care, Medical Knowledge, and Practice-Based Learning and Improvement.

Subjects:

Keywords:

  • Anemia–sickle cell
  • bone marrow transplantation
  • genetic therapy
  • stem cell transplantation

Curative therapies for sickle cell disease

Tools:

Journal Title:

The Ochsner journal

Volume:

Volume 19, Number 2

Publisher:

, Pages 131-137

Type of Work:

Article | Final Publisher PDF

Abstract:

Sickle cell disease (SCD) is an inherited hemoglobinopathy associated with severe morbidity, impaired quality of life, and premature mortality. Hematopoietic stem cell transplantation (HSCT) is the only curative treatment available for patients with SCD and has a >90% event-free survival when a matched related donor is used. However, availability of human leukocyte antigen (HLA)effidentical sibling donors for the SCD population is limited. The use of HLA-matched unrelated donors or related haploidentical donors has the potential to expand the donor pool. Methods: We reviewed the current literature on the indications for SCD transplantation, donor options, and the emerging use of gene therapy as a treatment option. Google Scholar and PubMed were searched using the terms SCD, bone marrow transplantation, donor sources, gene therapy, HSCT, and HLAmatching. Additional articleswere identified fromthe bibliographies of retrieved articles. All articles were reviewed for pertinent information related to SCD and transplantation. Results: HSCT has the potential to establish donor-derived normal erythropoiesis with stable long-term engraftment, amelioration of symptoms, and stabilization of organ damage. The majority of HSCT has been performed in children fromHLA-identical sibling donors and has resulted in excellent rates of survival. The use of alternate donors such as HLA-matched unrelated donors and haploidentical donors has the potential to expand the applicability of HSCT for SCD. Early results in gene therapy for SCD are encouraging.

Copyright information:

© 2019 Academic Division of Ochsner Clinic Foundation. All rights reserved.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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