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Allogenic hematopoietic stem cell transplantation in sickle cell disease

Galal, Ahmeda; Asslan, Monab,c

doi: 10.1097/MOH.0000000000000545
HEMATOPOIETIC STEM CELL TRANSPLANTATION: Edited by David Rizzieri
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Purpose of review Discussing the currently available HSCT options for Hb SS patients highlighting advantages and disadvantages of each modality in the light of recently published data.

Recent findings When MSD is available, myeloablative regimen is the preferred approach for otherwise healthy children whereas the nonmyeloablative (NMA) regimen is of choice for adults as well as children with SCD-associated morbidities. Mixed chimerism is common especially with NMA conditioning and is usually enough for cure. Alternative donor HSCT outcomes are progressively improving especially with posttransplant cyclophosphamide for GVHD prophylaxis.

Summary Recent studies comparing HSCT and chronic transfusion in Hb SS patients increasingly come in favor of HSCT arm. Advances in HSCT field led to donor pool expansion and better tolerated regimens. It is easier now to tailor a personalized transplantation plan for almost every patient. A successful management plan should be sufficiently comprehensive addressing patients’ and families’ social and psychological concerns to ensure compliance and improve outcome.

aDivision of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA

bDepartment of Internal Medicine, Faculty of Medicine

cTanta BMT Unit, Tanta Educational Hospital, Tanta University, Egypt

Correspondence to Ahmed Galal, MD, Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, 2400 Pratt St Suite 5000, DUMC Box 3961, Durham, NC 27710, USA. Tel: +1 919 668 1000; e-mail: ahmed.galal@duke.edu

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