Hematopoietic stem cell transplant therapy, clinical trials, complications, and quality of life for patients with Sickle cell anemia: Clinical potential and future perspectives

H. Verma, Yashwant Kumar Ratre, L. Bhaskar, Tarun Sahu, Devendra Purushottam Lingojwar
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Abstract

Background: Sickle cell anemia (SCA) is an inherited monogenic disorder. The clinical symptoms of SCA are protean, including vaso-occlusion, hemolysis, early stroke, leg ulcers, multi-organ failure, and increased risk of premature death. Hematopoietic stem cell transplantation is the only treatment identified to reduce SCA-related organ damage. Unfortunately, graft rejection is a significant impediment to these strategies. Materials and Methods: The current standard of treatment for the past two decades is limited to myeloablative-matched sibling donors, which is likely to be only for minor patients and is feasible for non-malignant giant disease. Cumulative studies showed that HSCT increases overall survival and quality of life in patients with SCA. Results: Hematopoietic stem cell transplantation (HSCT) is significantly associated with a higher risk of graft versus host disease and moderate mortality risk. New strategy lacking standard donors includes cord blood, matched unrelated donors/ Haploidentical donors. Conclusion: This review summarized evidence from HSCT clinical trials from different transplantation methods, specific HSCT and HSCT-related health problems that need to be addressed in medical contexts with patients and family members, and other areas that enhance the quality of life in SCA.
镰状细胞性贫血患者的造血干细胞移植治疗、临床试验、并发症和生活质量:临床潜力和未来展望
背景:镰状细胞性贫血(SCA)是一种遗传性单基因疾病。SCA的临床症状多种多样,包括血管闭塞、溶血、早期中风、腿部溃疡、多器官衰竭和过早死亡风险增加。造血干细胞移植是唯一确定的减少sca相关器官损伤的治疗方法。不幸的是,移植物排斥反应是这些策略的重大障碍。材料和方法:在过去的二十年中,目前的治疗标准仅限于骨髓匹配的兄弟姐妹供体,这可能只适用于未成年患者,对于非恶性巨大疾病是可行的。累积研究表明,移植可提高SCA患者的总体生存率和生活质量。结果:造血干细胞移植(HSCT)与较高的移植物抗宿主病风险和中等死亡风险显著相关。缺乏标准献血者的新策略包括脐带血、匹配的非亲属献血者/单倍体相同献血者。结论:本综述总结了来自不同移植方法的HSCT临床试验的证据、特定的HSCT和HSCT相关的健康问题,这些问题需要在患者和家庭成员的医疗环境中解决,以及其他可以提高SCA患者生活质量的领域。
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