Current trends in the management of sickle cell anemia

Although there has been enormous accumulation of knowledge about the molecular biology of sickle cell anemia, progress in clinical management has not been very impressive. Recently, however, the use of pharmacological agents, especially hydroxyurea, to manipulate HbF levels, bone marrow transplantation for selected cases and research into gene therapy have re-kindled hope for successful control and "cure" of the disease. The inherent variability in the clinical course of the disease, however, means that these new modalities of treatment are not appropriate for all patients. In this article the determinants of clinical variability and the available management options are reviewed especially as applicable to patients in the Arabian Peninsula