Bone Marrow Transplant as a cure for SCD


This discussion is addressing Bone Marrow Transplantation (BMT). At present, the cure there is for sickle cell is Bone Marrow Transplantation (BMT). This provides information you may wish to know about BMT.
Please feel free to send in any further questions and comments.

#CureForSickleCell

QUESTION: Is there a CURE for SICKLE CELL ANAEMIA (Haemoglobin SS)?
ANSWER: YES, there is a cure for sickle cell in the form of Bone Marrow Transplantation (BMT). BMT for sickle cell has been around since the late 1980’s – although still not widely available.

WHAT YOU SHOULD KNOW ABOUT BONE MARROW TRANSPLANTATION (BMT):

WHAT IS BONE MARROW TRANSPLANTATION? BMT for sickle cell is a procedure whereby cells from the bone marrow of a donor (ie someone who is Haemoglobin AA or AS) are transplanted into someone with Haemoglobin SS

WHERE DO THE DONATED CELLS COME FROM FROM?: Bone marrow cells are usually taken from the hip bone of the donor – who must have either Haemoglobin AA or AS. Usually, a brother or sister of the patient is preferred.

BEFORE BONE MARROW TRANSPLANTATION  CAN PROCEED, 3 MAJOR REQUIREMENTS MUST BE MET:
Identify the best donor (ie best match for the patient). Blood tests will determine who the best match is.
Next, both the donor and the patient will have pre-transplant evaluations of the heart, lungs, kidney, etc.
Counseling and interviews with a psychologist and a social worker also are an important part of the process.

BMT must be done under sterile conditions and the recipient will be on admission in hospital for about 10 days before the transplant procedure and for up to 1 month after the procedure
The actual BMT procedure is in the form of transfusion (just like the usual blood transfusion); the donated bone marrow is in a blood bag and passed into the patient’s body through a vein over a few hours.
After the transfusion, the patient is monitored in hospital (on admission) over the period of about 1 month – under sterile conditions because they are vulnerable to infections at this time
The patient continues to be monitored after discharge for several months to be sure the marrow has “taken”.

THE PATIENT IS CURED BECAUSE:

They no longer have sickle cell crises and other symptoms of sickle cell
They begin to live life normally like people who are Hb AA or AS – without frequent visits to the hospital, etc
After the BONE MARROW TRANSPLANTATION procedure, when their genotype is checked by a blood test, they are found to have become Hb AA or AS – depending on the genotype of their donor.
IMPORTANT!: Although the patient is cured – as evidenced by cessation of crises and other symptoms of sickle cell, as well blood test showing a change in their genotype, they need to be aware that they can still pass the Sickle Cell gene (S gene) to their children. This is important.

BONE MARROW TRANSPLANTATION IS NOT RECOMMENDED FOR EVERYONE WITH SICKLE CELL:
BMT is associated with risks and sometimes serious complications
The doctors who carry out the procedure insist that a number of criteria are met
The doctors will often consider the severity of the patient’s sickle cell condition vis a vis the risks of the procedure, before recommending it

BMT IS EXPENSIVE: Most people travel abroad for the procedure and total cost of the procedure, air travel, food and board for about 6 months for patient and care giver add up to about a whopping N25m (twenty-five million Naira) per patient!

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