Sickle cell disease treatments that are not medications include red blood cell transfusions and stem cell transplant.
Red blood cell transfusions
This sickle cell treatment involves taking red blood cells from one person and giving them to another.
The red blood cells are obtained when someone donates (gives) blood. Once the laboratory receives the blood donation, the red cells are separated from the other parts of the blood and stored in a bag in a special refrigerator.
All donated red blood cells are then tested for infections. If you need a transfusion, the health-care team will make sure the red blood cells you receive are closely matched to your blood type. This prevents negative reactions.
How is a transfusion given?
The red blood cells may be given into a vein through a regular IV (intravenous line) or through a central line or port. If you need a transfusion, you might receive it in a clinic or hospital inpatient unit.
Sometimes, a person with sickle cell disease only needs a single transfusion. Other times, they may need “chronic” transfusions, which could mean a transfusion once a month for many months or years.
Benefits of red blood cell transfusions for people with sickle cell disease
By providing normal red blood cells, transfusions:
- provide more hemoglobin to better deliver oxygen around the body
- reduce the percentage of sickle cells in your blood
- prevent your blood vessels from becoming blocked
- reduce your body’s need to produce new red blood cells. This is because transfused red blood cells live longer in the body than sickle-shaped red blood cells.
Transfusions are given for different health problems caused by sickle cell disease. For some problems, a blood transfusion may be a life-saving measure, for instance if it is used to treat severe anemia. Other times, chronic blood transfusions may help prevent a stroke, or prevent it from occurring again, or treat health problems such as acute chest syndrome.
Possible risks of a red blood cell transfusion
Like many medical treatments, red blood cell transfusions carry some risks.
Iron overload
Iron overload is when the iron from transfused red blood cells builds up and remains in the body. This build-up of iron can lead to major damage in the heart, liver and other organs.
After about two years of chronic transfusions, people often need to be treated with medicines to help remove iron from the body, called iron chelators.
Transfusion reactions
The body’s immune system may have a reaction to parts of the transfused blood. Symptoms include rash, itching, chills, fever and pain. More serious reactions may cause shortness of breath.
Transfusion reactions also occur when the body’s immune system makes molecules called antibodies against the transfused blood cells. These antibodies may develop after only a few transfusions and make it harder to find matched blood. If this happens, the person with sickle cell disease may need to stop receiving chronic transfusions and consider other treatments.
Stem cell (bone marrow) transplant
Another treatment is stem cell transplant (sometimes called bone marrow transplant). Bone marrow is the centre of the bone where blood cells are made by stem cells. It is obtained when someone donates their bone marrow.
Stem cell transplants replace the recipient's bone marrow with healthy bone marrow from a donor. This allows the body to make red blood cells that contain normal hemoglobin A.
These transplants are the only “cure” for sickle cell disease, but they can only be safely done if the bone marrow donor and person with sickle cell disease have matching tissue types. The treatment might not work if the donor bone marrow is rejected, or if the immune systems of the donor and person with sickle cell disease don’t co-operate with each other. In these cases, the person with sickle cell disease may experience serious skin, joint or gut damage, or serious infections that need to be controlled with strong medicines.
Make sure you talk to your health-care provider about all the risks and benefits of stem cell transplants.
