Pâleur et anémie: Que faire?

Pâleur et anémie: Que faire

Le suivi à long terme des cancers pédiatriques

Le suivi à long terme des cancers pédiatrique

Hematopoietic stem cell transplantation for sickle cell anemia

Hematopoietic stem cell transplantation is the only therapy able to cure sickle cell anemia at the present time. So far, transplantations have been undertaken in approximatively 140 sickle cell patients all over the world, with good results. The selection of patients for transplantation remains a subject of dilemma because of the unpredictable course of the disease and the lack of valuable prognostic markers. The selection criteria accepted so far concern young patients under the age of 16, with a morbid course of the disease and having a HLA-compatible sibling. In Belgium, patients going back to their country of origin were also considered for transplantation. For 100 patients who underwent transplantation in Europe, the current Kaplan-Meier estimates of overall survival, event-free survival, and disease-free survival rates are 90%, 79%, and 81%, respectively. Benefits and side effects are analyzed

Bone marrow transplantation for sickle cell disease. The European experience.

PURPOSE: In Belgium and France, 42 patients underwent bone marrow transplantation (BMT) for treatment of sickle cell disease. PATIENTS AND METHODS: The patients were young and symptomatic, but without chronic organ damage. Engraftment occurred in all patients and was sustained in 36. These 36 patients became free of symptoms and had a change in electrophoresis of their hemoglobin toward the donor's pattern. RESULTS: In five patients, engraftment was followed by bone marrow rejection. Two of these five patients underwent a second transplant, one at 62 days and the other at 21 months after the first transplant, and they are both doing well. The other three patients had autologous recovery of their own bone marrow. One patient died 3 months after marrow transplant of complications of graft-versus-host disease (GVHD). All the other patients are alive, with follow-up ranging from 1 to 75 months. CONCLUSIONS: Concerning the long-term side effects, six patients had chronic GVHD disease. So far, eight patients returned to Africa where they are continuing to do well

Bone marrow transplantation for sickle cell anemia.

The use of bone marrow transplantation for hemoglobinopathies was first proposed in thalassemia major and is now the therapy of choice for young patients affected by this disorder and having a suitable donor. Even though bone marrow transplantation is very effective in treating sickle cell anemia, enthusiasm for it is restrained by the unpredictable course of the disease. Selection criteria are difficult to establish and vary among medical teams and their patients' characteristics. Some of the factors playing a role in the decision are summarized in this article. They include genetic and environmental factors, features of the patient such as age or the presence of organ damage, and the possibility of using new alternative therapeutic approaches