Treatment for sickle cell disease in Africa: should we invest in haematopoietic stem cell transplantation?

Abstract

Sickle Cell Disease (SCD) is a multi-organ haemoglobinopathy with the greatest disease burden in sub-Saharan Africa. Hydroxyurea is the only available drug treatment for SCD, its major drawback being a reasonable proportion of non-responsive patient and the resistance of some patients/parents to comply with this treatment, due to potential side effects. We recognize the need to study and improve the use of hydroxurea for treatment of SCD in Africa; however, haematopoietic stem cell transplantation is an established treatment modality with much success in the first world, and rarely in Africa. In this commentary, we propose to shift from symptom management to preventative and curative measures for SCD; andadvocate exploring the establishment of stem cell transplantation centresin sub-Saharan Africa.

Keywords

• sickle cell disease
• hydroxyurea
• haematopoietic stem cells transplantation
• africa