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New Transplant Is Hope As Cure For Sickle Cell Anemia

By Leonard E. Colvin

Chief Reporter

New Journal & Guide

   Each day 80,000-plus Americans suffer with Sickle Cell Anemia, mainly persons of African descent.  Another 2 million Americans, not showing any signs of the disease, carry the trait and could pass it on to their children.
Sickle Cell Anemia is an inherited disease that deforms the body’s red blood cells. When these abnormally shaped cells  pass through arteries into vital organs where they carry oxygen, people with the disease can experience episodes of extreme  pain. Over time, their key organs, especially the liver and kidneys, can be damaged and their lives threatened.
   There  are few medicines which can effectively treat Sickle Cell Anemia. Painkillers and various antibiotics help to make life more comfortable. In a few cases, treatment has come from a 100 percent bone marrow transplant donated by someone with a compatible genetic and biological make-up.

Now, a new breakthrough bone marrow transplant procedure is being developed at the Johns Hopkins Medical Center in Baltimore using a “half match” from a parent, sibling or close relative.
    Johns Hopkins hemotologist Dr. Robert Brodsky and his team, say that other transplant procedures have been in use for the past 20 years.  These old procedures use high doses of chemicals to kill off the individual’s original bone marrow production system.
    The new procedure no longer has to destroy all of the individual’s original bone marrow production systems.  Instead just enough chemotherapy can be administered to suppress  the original immune system which keeps it from rejecting the newly transplanted bone marrow.
   The Johns Hopkins procedure would be less lethal and the chemicals less toxic to the  body, especially someone whose immune system and overall health are not the most stable. Its mortality rate is  5 to 10 percent.
   Having no other options except death, some three years ago, Pamela Newton was of the first patients to realize success using the new procedure. Newton, now 35, no longer uses pain killers or drugs to help her body adopt to the procedure. Three days after receiving the transplant, Newton was given high doses of Cyclophoshosphamide. While  the new bone marrow is taking hold in the body,  this powerful drug kills  off the donor’s  lymphocytes which make up the basic components of the immune system. This keeps the body from rejecting the new cells and spurs the production of new red blood cells in the recipient’s body.
The New Journal and Guide talked  to Dr. Brodsky  and to the heads of the two leading Sickle Cell Anemia advocacy agencies in Hampton Roads. Both are optimistic about the “breakthrough”  treatment and possible cure for sickle cell,  but point to some stumbling blocks.

Posted May 14, 2008

   
      Johnny Tidwell is the Director of the Peninsula  Association for Sickle Cell Anemia, which covers the Cities of Hampton, Newport News and  Williamsburg. Tidwell, who is now 55 years old, said he was diagnosed  with Sickle Cell Anemia at age 6.  I have not been hospitalized since 1999, so I just do what my doctors tell me and live a peaceable life. I work and stay active to keep going. I hope the new procedure can help those it can. We need to know more about it. I think we may see some hope. ”
    There are about 600 variations of Sickle Cell Anemia. Mr. Tidwell has  the  “Sickle C”  form of the disease. 
   Dr. Brodsky says that Black men  like Mr. Tidwell, who have lived beyond the life expectancy of 42 years, have a strain of the disease which is less severe than some others.
   “The people who call me are at their wits’ end with the disease,” said Dr. Brodsky. “They are losing their sight, they are about to lose the use of a critical organ. They are no longer being able to work  and function normally.  But our procedure can be  effective for both young and older people who are interested in seeking relief. They have nothing else to lose.”
   Dr. Brodsky said one of his biggest stumbling blocks is cost. He said the procedure costs from $50,000 to over $300,000.
   “Our problem or stumbling block is not a medical one, but the cost of  the procedure…and getting someone to pay for it,” said Dr. Brodsky.   “We need insurance companies, third party payers,  who are willing to pay for a procedure that has a 70 percent and higher successful rate.”
  Despite being told that he may not live beyond his teens, Tidwell said he has  lived a relatively normal life, including playing sports, and working at the Naval Shipyard for 20 years until he was forced to retire because of complications from the disease.
   Although he has heard about the new procedure being developed in Baltimore,  people of his age, he said, have little to cheer about.
   Over the years, the procedures used prior to the  emergence to the Johns Hopkins procedure, saw about 200 people who  had happy outcomes due to transplants and most were young.

   The John Hopkins procedure may provide hope for both young and older people.
   But Mr. Tidwell is not sure. He has lived past the 42 years of life expectancy for Black men who have Sickle Cell Anemia.

   “I have been told that the older you are, the less chance that such procedures will help people my age,” said Tidwell.  “Over the years I have had so many painful episodes which have caused damage to my organs and joints.

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