The dream of a permanent cure for sickle cell disease has recently become a reality as the Lagos University Teaching Hospital (LUTH) successfully performed bone marrow transplants on sickle cell anaemia patients. This groundbreaking treatment now makes the procedure accessible to Nigerians within their home country.
Professor Wasiu Adeyemo, the Chief Medical Director (CMD) at LUTH, emphasised the significance of this achievement, stating that, “Nigeria bears the heaviest burden of sickle cell disease worldwide.” With this breakthrough, there is newfound hope for relief and comfort for sickle cell patients who endure a daily cycle of pain.
Sickle cell anaemia (SCA) is a genetic disorder affecting haemoglobin production in red blood cells. It is characterised by abnormal haemoglobin, known as sickle haemoglobin, which causes red blood cells to become misshapen, rigid, and prone to breaking down. Unlike normal red blood cells, which are flexible and disc-shaped, allowing easy movement through blood vessels, sickle cells become crescent-shaped and can obstruct small vessels. This leads to anaemia, pain episodes (crises), increased risk of infections, organ damage, and a higher likelihood of stroke.
The global prevalence of SCA is staggering, with 300,000 babies born with the condition annually and approximately 20 million people living with the disease worldwide. The World Health Organisation recognises it as a significant public health concern. Africa bears the brunt of this burden, with about 1.9% of the population affected. Nigeria, in particular, has the highest prevalence, with 2-3% of its population—amounting to 4-6 million people—affected by SCA. The disease impacts one in every 40 births in the country.
Given these grim statistics, it is imperative for Nigeria to find solutions to this persistent menace. Professor Adeyemo explained the foundation of the breakthrough, noting that while comprehensive care programmes have improved survival rates for children, they have not significantly extended the lifespan of adults with the condition. This realisation led to the pursuit of bone marrow transplants using donors from family members as an established cure for the disease.
The CMD detailed the process: “The initial group of patients underwent bone marrow transplants. They received a treatment regimen of exchange blood transfusions, chemotherapy, and anti-infective prophylaxis to prepare them for the infusion of bone marrow stem cells harvested from family donors. These cells were processed and administered, followed by immediate post-transplant care within the hospital’s transplant unit.”
Professor Adeyemo credited the Sickle Cell Foundation Nigeria (SCFN) for its years of work in establishing a high-quality, safe bone marrow transplant programme that meets international standards for curing sickle cell disease. A post-transplant clinic, the first of its kind in sub-Saharan Africa, was established in 2019 to provide care for patients who had previously travelled abroad for bone marrow or stem cell transplants, thereby developing clinical expertise in post-transplant care.
While LUTH’s breakthrough is commendable. It is worth noting that a similar feat was achieved about a decade ago when a sickle cell transplant was performed on a young boy at the University of Benin Teaching Hospital. The lack of follow-up on that earlier success has led some Nigerians to question the sustainability of LUTH’s current trials and breakthrough.
Despite this scepticism, LUTH’s success story deserves applause. The hospital should be encouraged to build on this achievement and extend its impact across the country through increased awareness about the disease. With proper education and consciousness, sickle cell is preventable.
The importance of prevention cannot be overstated. Sickle cell occurs when two AS carriers marry and both contribute the S chromosome to their child, resulting in a life marked by perpetual pain, depression, and anger. Regardless of the love between two individuals, such marriages should be avoided rather than relying on prayers or declarations that “what God cannot do does not exist.” While divine intervention is not discounted, on medical grounds, religious bodies performing marriages should be urged to make genotype testing mandatory for prospective couples.
In the meantime, newborn screening programmes to detect SCA early, improved healthcare infrastructure, and access to treatments including gene therapy and stem cell transplantation, as demonstrated by LUTH, can provide relief for vulnerable sickle cell sufferers and reduce trauma for their families. These efforts represent a significant step forward in addressing this challenging health issue in Nigeria and beyond.
