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Conditioning Regimens

A survey on patient perception of reduced-intensity transplantation in adults with sickle cell disease

Bone Marrow Transplantation volume 39, pages 447–451 (2007)Cite this article

Abstract

The development of reduced-intensity conditioning (RIC) and the success of BMT for paediatric sickle cell disease (SCD) have raised the possibility of revisiting this prospect in adults as well. In a chronic debilitating disorder managed with supportive therapy, the patients' perception is critical in the advancement of any potential curative therapy. To explore this aspect, we undertook a questionnaire-based survey on 30 adults with SCD. Sixty two per cent of the patients were ready to accept a transplant-related mortality (TRM) >10%; 30% of them a TRM >30%. A risk of graft failure (GF) >10% was acceptable to 64%, with a risk >30% acceptable to 41%. Infertility was acceptable to only 50%. Chronic graft-versus-host disease (GVHD) was unacceptable to the majority (80%). Seventy six per cent% of patients had a full sibling and 60% were willing to participate in a clinical trial of RIC transplantation. This survey suggests that the majority of adults with SCD might be willing to consider a curative option such as RIC transplantation even with a high TRM or GF. The major concerns relate to chronic GVHD and infertility. There is an urgent need to explore RIC transplants in SCD patients within the framework of a clinical trial, considering patient perception regarding cure and complications.

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Acknowledgements

We thank Dr Sudhir Tauro for his help in conducting this survey.

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Authors and Affiliations

  1. Department of Haematology and Bone Marrow Transplantation, St George's Hospital, London, UK

    S Chakrabarti

  2. Department of Haematology, City Hospital, Birmingham, UK

    D Bareford

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  1. S Chakrabarti
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  2. D Bareford
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Correspondence to S Chakrabarti.

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Chakrabarti, S., Bareford, D. A survey on patient perception of reduced-intensity transplantation in adults with sickle cell disease. Bone Marrow Transplant 39, 447–451 (2007). https://doi.org/10.1038/sj.bmt.1705622

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