Medical Treatments for Sickle Cell Disease
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Blood transfusions]]> increase the number of circulating red blood cells, treat anemia, improve oxygen delivery to organs and tissues, and prevent strokes in high-risk patients.
You may receive whole blood or packed red blood cells. A blood test will be performed to determine your blood type and ensure you receive compatible blood. The blood will be given to you through a needle inserted into your vein. An antihistamine, such as ]]>Benadryl]]> , is sometimes given to help prevent allergic reactions during the transfusion. Your heart rate, breathing, and blood pressure will be carefully monitored throughout the procedure.
Bone Marrow Transplant
Some medical centers are performing bone marrow transplants]]> in an attempt to cure sickle cell disease. This involves replacing the bone marrow of a sickle cell patient with normal bone marrow from a healthy donor. There are many complications involved in this procedure, and it can be difficult to find a donor whose bone marrow characteristics match yours. If a good match isn’t found, your body will reject the new bone marrow.
If you undergo a bone marrow transplant, the first step will be to destroy your current bone marrow using high-dose chemotherapy agents. You’ll then be placed on immunosuppressive drugs to prevent your body from rejecting the new donor marrow. You’ll need to take these drugs for the rest of your life. Once the donor has had bone marrow removed, it will be filtered and then dripped into your body through a tube inserted into a large vein in your chest.
Because people with sickle cell anemia are particularly prone to infections with certain types of bacteria, it is very important that children between the ages of 2 and 5 receive the pneumococcal vaccine. This vaccine can prevent the development of pneumococcal pneumonia, a frequent complication for sickle cell patients.
While you are hospitalized for treatment of an acute sickle cell crisis, you’ll be given oxygen. This will help restore the appropriate amount of oxygen in your system and help stop other red blood cells from sickling.
Oxygen can be given to you through prongs at the opening of your nostrils or through a mask. The level of oxygen in your blood may be checked continuously by taping a small monitor (called a pulse oximeter) to your finger or toe.
Because dehydration can worsen symptoms and complications during an acute crisis, you’ll be given fluids through an intravenous needle during your hospital stay. These fluids will contain a careful balance of important chemicals (called electrolytes) that your body needs, including sodium, potassium, and sugar.
Many centers now use color doppler ultrasound for people with sickle cell to regularly check the rate of blood flow through the arteries in the neck. When blood flow speeds up there is an increased risk of stroke]]> , which is a potentially catastrophic sickle cell complication. With this type of screening, blood transfusions can be given when—or possibly before—the speed of blood flow rises to potentially dangerous levels, which can decrease the risk of stroke.
Cecil Textbook of Medicine . 22nd ed. W.B. Saunders Company; 2003.
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ .
Sickle Cell Disease Association of America website. Available at: http://www.sicklecelldisease.org/ .
Weiner CM. Harrison’s Principles of Internal Medicine . 17th ed. New York, NY: McGraw – Hill; 2008.
Last reviewed June 2008 by ]]>Mark A. Best, MD, MPH, MBA]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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