By Kunle Awosiyan
Barely two years that the Sickle Cell Foundation Nigeria, SCFN Inaugurated a Bone Marrow Transplant Centre at the Lagos University Teaching Hospital, two patients are currently undergoing the treatment.
A statement jointly signed by LUTH’s Chief Medical Director, Professor Wasiu Adeyemo, and SCFN’s National Director and Chief Executive Officer, Dr. Annette Akinsete, said this first set of patients admitted in the last week of August 2024 are currently undergoing immediate post-transplant care within the hospital.
It confirmed that the first set of patients has begun undergoing bone marrow transplants at LUTH. “They received a treatment regimen of exchange blood transfusions, chemotherapy, and anti-infective prophylaxis to prepare them for the infusion of bone marrow stem cells harvested from family donors.”
According to SCFN, in numerical terms, over 40 million Nigerians are healthy carriers of the sickle cell gene, while over 150,000 babies are born each year with sickle cell anaemia (Hb SS). This is by far the largest burden of the disorder anywhere in the world and most of these children would die in childhood from ignorance and lack of access to proper diagnosis and care.
In August 2023, a Lancet Haematology publication revealed that globally, between 2000 and 2021, the rate of children born with sickle cell disease increased by 13.7 percent, reaching an average of up to 515,000 babies per annum. The study also found that sickle cell-specific under-5 mortality was 11 times higher than deaths due to other causes, amounting to approximately 376,000 deaths from sickle cell disease annually compared to 34,400 deaths from other causes.
In a study, “Impact of Sickle Cell Disease on Affected Individuals in Nigeria: A Critical Review by Obi Peter Adigwe, Godspower Onavbavba and Solomon Oloche Onoja published by the National Library of Medicine, the disease was identified as a major healthcare issue in Nigeria, with highest prevalence of sickle cell disease globally, while also contributing significantly to high mortality rates of children under five years of age.
Findings from the study revealed that sickle cell disease had both health and social consequences. The study observed lack of sickle cell clinics with adequate state of the art equipment and well-trained personnel for prompt diagnosis and treatment of various clinical manifestations of sickle cell disease.
However, there was a ray of hope in 2022, when SCFN and LUTH collaborated to open a bone marrow transplant centre as a safe cure for sickle cell disease.
Speaking on the two patients that are currently undergoing the bone marrow transplant, Professor Wasiu Adeyemo said that the complexity and costs have severely limited those who can obtain this treatment, and most have sought the treatment outside Nigeria, which causes severe hardship for patients and families, only to come home with no local expertise for follow-up.
Our correspondent gathered that the cost of an average bone marrow transplant in Lagos can range from $ 43,000 to $46,000 depending on several factors including the type of transplant (autologous or allogeneic),. Explain the meaning and difference.
To Adeyemo, due to the high cost of the treatment, LUTH and SCFN established a bone marrow transfer programme to ensure that Nigerians can access a high-quality, safe bone marrow transplant that meets international standards for the cure of sickle cell disease.
“The establishment of comprehensive care programmes, including newborn screening, penicillin prophylaxis, and transcranial Doppler screening in children, is to identify those at risk of stroke.
“This is followed by using chronic blood transfusion therapy and the increasing use of hydroxyurea therapy, which has improved the proportion of children surviving into adulthood but has not improved the proportion of adults living to older age, especially for the most severely affected.
“But bone marrow transplant using a donor from a family member is an established cure for this disease, first used more than 30 years ago.”
He said that bone marrow transplant, now an approved therapy for children and adults with severe sickle cell disease, is a complex procedure requiring a multidisciplinary team approach and involves treatment and close follow-up for approximately 12 months. “The stem cell infusions took place on September 17 and September 19, 2024,” he said.
In June, Lagos State Governor inaugurated Paediatric Sickle Cell Centre at the Lagos State University Teaching Hospital.
The Centre was donated to LASUTH by the Office of the Senior Special Assistant to the President on Sustainable Development Goals (OSSAP-SDGs) to improve health outcomes for children with sickle cell disease.
Former Deputy Governor of Lagos State, Hon.Joke Orelope-Adefulire runs the office.
This facility, according to the state governor, Mr. Babajide Sanwo-Olu will provide comprehensive care, including early diagnosis, advanced treatment, and continuous management for children suffering from this debilitating condition.
The Chief Medical Director, LASUTH, Prof. Adetokunbo Fabamwo said the Sickle Cell Centre houses facilities for clinics, wards, daycare centre, investigation as well as educational and research activities exclusively for children afflicted with sickle cell disease.
He mentioned that the establishment of the Centre will take pressure off the usual crowded Paediatrics clinic and wards.