Blood Treatment for Sickle Cell Disease
At Hassenfeld Children's Hospital of New York at NYU Langone, doctors may recommend blood transfusions to prevent or treat certain complications in children with sickle cell disease. Blood transfusions are given as an intravenous (IV) infusion through a catheter that’s inserted into a vein in your child’s arm or leg. Our experts can identify children who are likely to benefit from this treatment.
For a small number of children with sickle cell disease, our doctors may recommend a stem cell transplant. This treatment, also given as an IV infusion, is a one-time procedure that can cure sickle cell disease.
Doctors may use blood transfusions to boost the level of normal red blood cells in children with sickle cell disease when they have episodes of more severe anemia.
Because transfusions increase the number of normal red blood cells, they can help to alleviate complications, such as acute chest syndrome—a reduction in oxygen that can cause coughing, chest pain, and shortness of breath. When used as a long-term therapy, blood transfusions can also prevent the occurrence of a stroke by reducing the number of abnormal red blood cells, which can narrow blood vessels and cause a stroke.
Depending on how much blood your child needs, the procedure can last one to four hours. Transfusions are usually given every three to four weeks.
Blood transfusions are generally safe, but repeated transfusions can cause allergic reactions or a buildup of iron in the body.
Our doctors use blood tests to monitor for these complications in children who receive frequent blood transfusions.
Stem Cell Transplantation
Doctors at Hassenfeld Children's Hospital perform stem cell transplantation in children with severe pain, anemia, chronic lung problems, or a high risk of stroke.
Stem cells, made in the bone marrow, produce new blood cells. In children with sickle cell disease, a stem cell transplant involves introducing new, blood-producing stem cells through an IV infusion.
Healthy stem cells are taken from a donor, such as a sibling, who has the same type of human leukocyte antigen, a protein found in cells. This prevents your child’s immune system from attacking the new stem cells as it would any foreign substance.
In the weeks before this procedure, doctors may treat your child with chemotherapy or radiation therapy to destroy abnormal blood-producing cells in the bone marrow. Because these treatments may suppress the immune system, our doctors take special care during this period to prevent your child from developing an infection.
Immunosuppressant medication is also given to reduce the risk of graft-versus-host disease, a condition in which the donated stem cells attack the host’s cells, usually in the skin and lining of the intestine.
Although stem cell transplantation itself takes only about 30 minutes to complete, your child may remain in the hospital for up to a month after the procedure to prevent infection. Doctors also monitor your child for signs of rejection and graft- versus-host disease.
Considerations Before Stem Cell Transplantation
Although stem cell transplantation offers some children symptom relief and can help to prevent serious complications, it is a procedure that requires careful consideration.
Graft failure may occur if the immune system attacks the transplanted stem cells with antibodies, preventing them from producing new blood cells. Children who have graft failure may need a second transplantation. If a child develops graft-versus-host disease and does not respond to immunosuppressant medication, organ damage may result.
Our specialists can counsel you about the benefits and risks of stem cell transplantation for your child.