Sickle Cell Disease Burden in Africa: Why Bone Marrow Transplant Matters

Usually after one year we stop all the immunosuppression — only 10 to 15% of patients need it for a longer duration, but in the majority of patients we stop immunosuppression after one year of transplant.

When a newborn baby is born, from the placental side of the cord, 25 ml of stem cells are collected and go to a public bank or a private bank, and later, if you want to do a transplant, you can use that unit. You can do it for any condition, but in India we don't prefer cord blood transplants because there are quite a number of issues with them — that's why we prefer adult donor transplants over a cord blood unit.

There is no role of bone marrow transplant in prostate cancer — none, and no research on it either. On registries: the biggest bank is in Germany, the second biggest in the US, but there are many other banks in other parts of the world — there isn't even a single bank in Africa. That's one of the reasons transplants aren't happening in Africa, other than South Africa and some in Benin City, Nigeria. All of you need to come together and have your own registry, so that if somebody requires stem cells, you have your own bank — you people have to come out with the solution.

That's a very good question, but there is no role of bone marrow transplant in cerebral palsy. There are researches going on about whether transplant helps for cerebral palsy, but we don't have an answer in black and white — at the present moment there is no indication for doing a transplant for cerebral palsy.

Sooner is better — it is better to do a transplant early — but we have done transplants even for adults. I showed a picture of a Nigerian person, Mr. Buhari, whose transplant was done at the age of 34, and he's doing well.

Sub-Saharan Africa carries about 75% of the world's sickle cell disease burden, and Nigeria is described as the sickle cell capital of the world.

Around 250,000 babies are born with sickle cell disease globally each year, a figure projected to rise to an estimated 1,400,000 births a year by 2050.

Fortis Memorial Research Institute, Gurgaon has performed more than 150 bone marrow transplants for sickle cell disease and over 1,800 transplants in total, including treating its first Nigerian sickle cell transplant patient roughly a decade before this masterclass.

Supportive measures such as penicillin prophylaxis, vaccination, hydroxyurea and exchange transfusion help manage complications but do not cure the underlying disease, which is a key reason many families explore bone marrow transplant in India as a curative option.