Should young children with sickle cell disease and an available human leukocyte antigen identical sibling donor be offered hematopoietic cell transplantation? | Zendy

Lakshmanan Krishnamurti | Zendy

Open Access

Should young children with sickle cell disease and an available human leukocyte antigen identical sibling donor be offered hematopoietic cell transplantation?

Author(s) -

Lakshmanan Krishnamurti

Publication year - 2020

Publication title -

hematology/oncology and stem cell therapy

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 0.666

H-Index - 22

eISSN - 1658-3876

pISSN - 2589-0646

DOI - 10.1016/j.hemonc.2019.12.008

Subject(s) - sibling , human leukocyte antigen , medicine , hematopoietic stem cell transplantation , hematopoietic cell , disease , transplantation , immunology , young adult , quality of life (healthcare) , beneficence , pediatrics , haematopoiesis , autonomy , stem cell , antigen , biology , psychology , developmental psychology , genetics , nursing , political science , law

Availability of an HLA-identical sibling donor raises the question, "should young children with SCD, and an available HLA identical sibling donor be considered for hematopoietic cell transplantation (HCT) even before they manifest severe clinical presentations of sickle cell disease (SCD)?" The overall survival (OS) and event free survival (EFS) following HCT from an HLA identical sibling is excellent in young children, and worsen with increasing age at HCT. SCD related complications, organ dysfunction, quality of life, and risk for premature mortality all worsen with age. The ethical principles of non-maleficence, beneficence, autonomy and justice all support the consideration of this life, quality of life, and organ saving therapy at a young age.

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