For many years, sickle cell anemia has had no cure. Till today, it is still perceived that it has no cure. The truth is, there is one treatment that can completely cure someone with sickle cell and that is “The Bone Marrow Transplant.” In today’s post, I will share some insights on the intricacies of the transplant. As I always emphasize, I am not a medical doctor neither do I work in the medical field so I encourage you to research as well, read widely and ask questions if you want to know more about it.
What is the “Bone Marrow Transplant?
This process, also known as a stem cell transplant, involves replacing the abnormal stem cells in the bone marrow with healthy cells from an eligible donor, which could be either a brother or a sister. It is currently the only known cure for sickle cell anemia.
Who is eligible for a bone marrow transplant?
It is important to note that, not all sickle cell patients are eligible to undergo the bone marrow transplant due to its significant associated toxicity. It is only performed on patients with severe sickle cell who have complications such as stroke, acute chest syndrome, recurrent pain, retinopathy, etc.This procedure is undertaken only if the benefits outweigh the risks associated to the patient’s health.
Who can be a donor?
For the most part, siblings without sickle cell are often the first point of contact for donors. The sibling should have a matching bone marrow and should have the same mother and father with the recipient. Another source could be a volunteer who has the same bone marrow as the patient. In other instances, there could be a half-matched relative but this case is often used as research with hopes that it will work.
How is the procedure carried out?
The patient with sickle cell is treated with chemotherapy to eliminate their own unhealthy bone marrow to create space in the bone marrow for healthy stem cells. The patient then receives the healthy bone marrow cells (donated by a sibling/volunteer) through the veins, similar to a blood transfusion procedure. Surgery is usually not involved. There are many tests that have to be run on patients to make sure they are fit to undergo the procedure. The most challenging part is finding a perfect match, which can be a difficult task. Going through with the procedure without a good match can cause several complications.
Risks associated to the Bone Marrow Transplant
All medical procedures have risks that one should be aware of before proceeding with the treatment. In this instance, there are many risks associated with having a bone marrow transplant. Firstly, there is the risk of infections. Chemotherapy lowers white blood cells which normally fight and prevent infections, therefore, once the process of chemotherapy begins, it lowers the patient’s risk of fighting any infections they may receive. Medications are often administered to fight against these infections, but if they do not work, it may lead to several health complications including death.
Secondly, there is a possibility of the body rejecting the new red blood cells altogether or the unfortunate incident of the body sensing the introduction of different red blood cells and may begin to attack the new blood cells; it is usually referred to as “graft-versus-host-disease”. Research has shown that it happens in about 10% of patients with matched donors and even higher in transplants using other donors (Bone Marrow Transplant for Sickle Cell Children). The complications that arise from this situation can lead to a higher risk of infection or even death. In some instances, if the bone marrow rejects the new blood cells, they may have to give back the old blood cells which means, you get back the sickled blood cells (that would be so disappointing…sigh).
Another risk is that some patients who go through this procedure are unable to have their own children in the future. This is due to one of the side effects of the drugs used while preparing for the transplant.
There are many other risks aside from the ones I have highlighted. In fact, I just scratched the surface, so I implore you to do more reading and research on this topic. Here are some resources to begin with:
In spite of all these risks, there is the possibility of going through this process and coming out of it sickle cell anemia free. I believe that before one goes through this type of procedure, research should have been thorough and a lot of questions answered. I urge anyone considering this treatment to make this decision with the right information but also be hopeful that this will work, after all, with God, all things are possible.