Evidence-Based Minireview: In young children with severe sickle cell disease, do the benefits of HLA-identical sibling donor HCT outweigh the risks?
Hematology Am Soc Hematol Educ Program
; 2021(1): 190-195, 2021 12 10.
Article
in English
| MEDLINE | ID: covidwho-1582134
ABSTRACT
In case 1, a 14-month-old male child with sickle cell disease (SCD) was referred for evaluation for an allogeneic hematopoietic stem cell transplant (HCT). The patient had a history of dactylitis 3 times in his first year of life and febrile episodes twice at the consult. His 4-year-old sister was found to be human leukocyte antigen (HLA) identical. The patient was started on hydroxyurea (HU) at 2.5 years of age. His parents again sought consultation when he was 5 years old because of concerns about his medical condition. At the time, the patient had experienced 2 vaso-occlusive pain episodes (VOEs) requiring hospitalization during the previous 2 years. He had also experienced intermittent pain crises requiring rest at home for 2 to 3 days. The child has not attended school in person due to the COVID-19 pandemic. The family is considering HCT but is ambivalent about it because of potential toxicity. In case 2, an 8-year-old female child is 3 years out from HCT for SCD from her HLA-identical sibling. Before HCT, despite receiving HU, she had experienced >5 VOEs requiring hospitalization and 2 episodes of acute chest syndromes in the previous 3 years. She had also been missing almost 50 days of school days each year. After HCT, she is now attending school regularly and participating in all normal age-appropriate activities. The parents believe that HCT has been transformative in their child's life.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Hematopoietic Stem Cell Transplantation
/
Anemia, Sickle Cell
Type of study:
Case report
/
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Language:
English
Journal:
Hematology Am Soc Hematol Educ Program
Journal subject:
Hematology
Year:
2021
Document Type:
Article
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