Kehinde Adeleye
As part of a bold initiative to combat sickle cell disease in Nigeria, the Lagos University Teaching Hospital (LUTH) and the Sickle Cell Foundation Nigeria (SCFN) have joined forces to launch a groundbreaking bone marrow transplant program.
In a statement jointly issued by Prof. Wasiu Adeyemo, Chief Medical Director of LUTH, and Dr. Annette Akinsete, National Director of SCFN, the urgent necessity for this program was underscored, highlighting the impact of the disease on patients and their families.
Sickle cell disease poses significant health challenges in Nigeria, resulting in life-threatening complications, organ damage, and reduced life expectancy for affected individuals. “Recognising the gaps in care for individuals affected by the disease in Nigeria, SCFN and LUTH established a bone marrow transplant programme at LUTH.”
“Bone marrow transplant using a donor from a family member is an established cure for this disease.” They said.
The statement also outlined the comprehensive care programs established, such as newborn screening, penicillin prophylaxis, and Transcranial Doppler screening in children to identify those at risk of stroke.
“This is followed by chronic blood transfusion therapy and the increasing use of hydroxyurea therapy, which has improved the proportion of children surviving into adulthood. But it has not improved the proportion of adults living to older age, especially for the most severely affected.”, the statement said.
The program builds on previous initiatives, including the establishment of a post-transplant clinic in 2019, which was the first of its kind in sub-Saharan Africa. LUTH provided post-transplant care to patients who had previously traveled abroad for treatments.
FIRST PATIENTS
The statement 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.”
The stem cell infusions took place on September 17 and September 19, 2024.
Currently, both patients are receiving immediate post-transplant care within the transplant unit at LUTH.
Challenges in bone marrow transplant
Bone marrow transplant, is recognized as an established cure for sickle cell disease. It comes with its own set of complications, including infection, graft-versus-host disease, infertility, and even death.
However, advancements over the last 20 years have significantly improved the procedure, making it a viable option for both children and adults with severe cases. The statement noted, “Bone marrow transplant is now an approved therapy… requiring a multidisciplinary team approach and involves treatment and close follow-up for approximately 12 months.”
Despite its effectiveness, the complexity and high costs of bone marrow transplants have pushed many patients to seek treatment abroad, causing financial and emotional strain on families.
LUTH’s bone marrow transplant program is supported by a multidisciplinary team comprising pediatricians, adult hematologists, psychiatrists, anesthesiologists, nurses, dieticians, pharmacists, and other health personnel.
The program is guided by experts, including Prof. Adetola Kassim from Vanderbilt University Medical Center and Prof. Josudela Fuente from the Imperial College London Healthcare NHS Trust, who joined the team in 2022.
