Ethical Challenges in Hematopoietic Cell Transplantation for Sickle Cell Disease.

Autor: Nickel RS; Division of Hematology, Children's National Health System, Washington, District of Columbia. Electronic address: rnickel@childrensnational.org., Kamani NR; Center for Cellular Therapies and Research, AABB, Bethesda, Maryland.
Jazyk: angličtina
Zdroj: Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation [Biol Blood Marrow Transplant] 2018 Feb; Vol. 24 (2), pp. 219-227. Date of Electronic Publication: 2017 Sep 01.
DOI: 10.1016/j.bbmt.2017.08.034
Abstrakt: Hematopoietic cell transplantation (HCT) using an HLA-identical sibling donor offers a very high likelihood of cure with good outcomes for patients with sickle cell disease (SCD), and alternative donor HCT for SCD is an area of active clinical research. Thus, HCT is a potential option for a growing number of patients with SCD. This expanded use of HCT has raised several ethical questions. Who is eligible for HCT, in terms of both disease severity and psychosocial factors? Should affected children with matched sibling donors undergo HCT only when they have declared themselves as having significant symptomatology? Regarding donors, special ethical challenges include the use of preimplantation genetic diagnosis to conceive an HLA-identical sibling. In this review, we critically analyze various ethical challenges related to HCT for SCD, and offer recommendations to guide clinical care.
(Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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