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Hematopoietic Stem Cell Transplantation in Adult Sickle Cell Disease: Problems and Solutions

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TJH_32_3_195_205.pdf (176.5Kb)
Date
2015
Author
Ozdogdu, Halkan
Boga, Can
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Abstract
Sickle cell disease-related organ injuries cannot be prevented despite hydroxyurea use, infection prophylaxis, and supportive therapies. As a consequence, disease-related mortality reaches 14% in adolescents and young adults. Hematopoietic stem cell transplantation is a unique curative therapeutic approach for sickle cell disease. Myeloablative allogeneic hematopoietic stem cell transplantation is curative for children with sickle cell disease. Current data indicate that long-term disease-free survival is about 90% and overall survival about 95% after transplantation. However, it is toxic in adults due to organ injuries. In addition, this curative treatment approach has several limitations, such as difficulties to find donors, transplant-related mortality, graft loss, graft-versus-host disease (GVHD), and infertility. Engraftment effectivity and toxicity for transplantations performed with nonmyeloablative reduced-intensity regimens in adults are being investigated in phase 1/2 trials at many centers. Preliminary data indicate that GVHD could be prevented with transplantations performed using reduced-intensity regimens. It is necessary to develop novel regimens to prevent graft loss and reduce the risk of GVHD.
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http://www.journalagent.com/tjh/pdfs/TJH_32_3_195_205.pdf
http://hdl.handle.net/11727/4046
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  • Tıp Fakültesi / Faculty of Medicine [1997]

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