Table 3.

Special considerations for HSCT in SCD populations

Challenge	Potential solutions
High incidence of graft failure	Consider HU pre-HSCT, consider early transplant before patients are allo-immunized from multiple transfusions.
High incidence of PRES	Use alternative methods such as sirolimus for GVHD prophylaxis. Use of anticonvulsants is standard but has not proven to be effective.
Incidence of infertility	Fertility preservation including offering gamete retrieval and cryopreservation should be discussed with all patients and their families prior to HSCT.
Chronic pain post-transplant	Consider a multi-disciplinary approach with psychiatry, neurology, and behavioral therapy.