Table 2.
Indications for Hematopoietic Stem Cell Transplantation from Matched Unrelated Donors for Patients with Sickle Cell Disease6,35-37
| Established Indications | Potential Indications |
|---|---|
| Neurologic symptoms | Neurologic sequelae from silent infarcts |
| • Overt stroke | |
| • High transcranial Doppler velocity (>200 m/s) | |
| Cardiac/pulmonary symptoms | Tricuspid regurgitation velocity >2.5 m/s |
| • Acute chest syndrome (≥1 episode while on a therapeutic dose of hydroxyurea) | Pulmonary hypertension |
| Bone/joint symptoms | |
| • Avascular necrosis/osteonecrosis (usually ≥2 joint involvement) | |
| Renal/genitourinary symptoms | Renal insufficiency (need for dialysis, nephrotic syndrome) |
| • Recurrent priapism requiring medical management | |
| Hematologic symptoms | |
| • Red cell alloimmunization from recurrent packed red blood cell transfusions | |
| Hepatic symptoms | Iron overload |
| Sickle-related liver injury | |
| Vaso-occlusive crisis | |
| • ≥2 hospitalizations for pain management despite being on therapeutic dose of hydroxyurea |