Allogenic bone narrow transplantation in sickle-cell diseases.

Abstract

Sickle-cell diseases are the most common inherited hemoglobinopathies worldwide. Improvement in survival has been seen in the last decades with the introduction of careful screening and prevention of complications and the introduction of hydroxyurea. Stem-cell transplantation is currently the only curative option for these patients and has been indicated for patients with neurological events, repeated vaso-occlusive crisis, any organ damage or presence of red blood cell antibodies. Related bone-marrow or cord-blood transplant has shown an overall survival of more than 90% with a disease-free survival of 90% in 1,000 patients transplanted in the last decades. The use of unrelated donors unfortunately has not shown the same good results, but better typing methods and improved support may improve the outcome with this source of stem cells in the future. In Brazil, only recently stem cell transplant from related donors has been included in the procedures performed in the public health system. The use of related bone marrow or cord blood and a myeloablative conditioning regimen are considered standard of care for patients with sickle-cell diseases. Transplants with non-myeloablative regimens, unrelated donors or haploidentical donors should be performed only in controlled clinical trials.

Long-Term Effects of Allogeneic Hematopoietic Stem Cell Transplantation on Systemic Inflammation in Sickle Cell Disease Patients

“…The management of SCD is a challenge (3,26,27) and allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only currently available curative treatment (28)(29)(30)(31). To date, hundreds of SCD patients have already been successfully transplanted worldwide (29,31).…”

Desenvolvimento De Doenças E Complicações Após Transplante De Medula Óssea / Development of Disease and Subsequent Complications of Bone Marrow Trasnplantation

“…Geralmente é feita uma incisão na crista ilíaca posterior, de onde é coletado 5ml de medula de cada local puncionado 5 . O transplante de medula óssea tem se tornado a única cura para determinadas doenças 6 . No entanto, a grande problemática com relação ao transplante é o desenvolvimento de doenças e algumas complicações que ocorrem em decorrência do mesmo 7 .…”