Cancer Treatment Today

Thalassemia major and sickle cell disease are the two most widely disseminated hereditary hemoglobinopathies in the world. The outlook for affected individuals has improved in recent years due to advances in medical management in the prevention and treatment of complications. However, hematopoietic stem cell transplantation is still the only available curative option. The use of hematopoietic stem cell transplantation has been increasing, and outcomes today have substantially improved compared with the past three decades. Current experience world-wide is that more than 90% of patients now survive hematopoietic stem cell transplantation and disease-free survival is around 80%. However, only a few controlled trials have been reported, and decisions on patient selection for hematopoietic stem cell transplantation and transplant management remain principally dependent on data from retrospective analyses and on the clinical experience of the transplant centers. Experience of HSCT in adult patients remains very limited, with very few centers performing HSCT in patients over the age of 18 years, and with TRM being persistently around 25%. However, the oOnsensus (Angelucci et al) is supportive of it in patients who are severely iron overloaded and not responding well to chelation.

Emanuele Angelucci, Susanne Matthes-Martin, Donatella Baronciani, Françoise Bernaudin, Sonia Bonanomi, Maria Domenica Cappellini, Jean-Hugues Dalle, Paolo Di Bartolomeo, Cristina Díaz de Heredia, Roswitha Dickerhoff, Claudio Giardini, Eliane Gluckman, Ayad Achmed Hussein, Naynesh Kamani, Milen Minkov, Franco Locatelli, Vanderson Rocha, Petr Sedlacek, Frans Smiers, Isabelle Thuret, Isaac Yaniv, Marina Cavazzana, Christina Peters, Hematopoietic Stem Cell Transplantation In Thalassemia Major And Sickle Cell Disease: Indications And Management Recommendations From An International Expert Panel. Haematologica May 2014 99: 811-820

Vanitha A Jagannath et al, Hematopoietic stem cell transplantation for people with ß-thalassaemia major. Cochrane Cystic Fibrosis and Genetic Disorders Group, Published Online: 5 OCT 2011, DOI: 10.1002/14651858.CD008708.pub2