title: First successful allogeneic hematopoietic stem cell transplantation for a sickle cell disease patient in a low resource country (Nigeria): a case report.
abstract: BACKGROUND
  Sickle cell disease (SCD) has a prevalence of 2-3% in Nigeria (population: over 150 million). We present our first allogeneic hematopoietic stem cell transplantation (HSCT) for a 7-year-old patient with severe sickle cell anemia and debilitating right-sided hemi-paraparesis.
  
  
  METHODS
  Conditioning was with (Reduced Intensity Conditioning (FLU/BU).[Fludarabine 160 mg/m2 (days -6 to -2) and Busulphan 16 mg/kg (4×25 mg 6 hly days -5 to -2) and Anti-thymocyte globulin(ATG)(ATGAM) total dose 500 mg (days -6 to -4)]. Graft versus Host Disease (GVHD) prophylaxis was with Cyclosporine A (2×50 mg daily) and Mycophenolate Mofetil (2×500 mg/day). Stem cell source was bone marrow harvested on the 28 September 2011 with 9.8×108 nucleated cells/kg in a total volume of 900 mL from his 14-year-old HLA-matched sibling (6/6). Neutrophil and platelet engraftment was day +18 and +21, respectively. At day +70 full blood count was a total white blood cell count of 3100/µl, absolute Neutrophil count 1200/µl, Hemoglobin (Hb) 11.3 g/dl, Platelet 198,000/µl, Hemoglobin phenotype AA, and no acute or chronic GVHD. He is clinically stable with a Chimerism at 2 years post-HSCT of 95% and responding to physiotherapy.
  
  
  CONCLUSIONS
  We have successfully performed a stem cell transplanted in a 7-year-old Sickle Cell Anemia case. With the assistance of Government and improved Health Insurance Policy, we could make HSCT available as a cure for many Nigerians with both malignant and non-malignant disorders.
authors.affiliation: Department of Hematology, University of Benin, Teaching Hospital, Benin, Nigeria.
authors.forename: Nosakhare
authors.initials: N
authors.lastname: Bazuaye
authors.affiliation: Department of Hematology, University of Benin, Teaching Hospital, Benin, Nigeria.
authors.forename: Benedict
authors.initials: B
authors.lastname: Nwogoh
authors.affiliation: Department of Hematology, University of Benin, Teaching Hospital, Benin, Nigeria.
authors.forename: Douglas
authors.initials: D
authors.lastname: Ikponmwen
authors.affiliation: Department of Surgery, University of Benin, Teaching Hospital, Benin, Nigeria.
authors.forename: Omorodion
authors.initials: O
authors.lastname: Irowa
authors.affiliation: Department of Cardiothoracic, University of Benin, Teaching Hospital, Benin, Nigeria.
authors.forename: Stanley
authors.initials: S
authors.lastname: Okugbo
authors.affiliation: Department of Anaesthesia, University of Benin, Teaching Hospital, Benin, Nigeria.
authors.forename: Ime
authors.initials: I
authors.lastname: Isa
authors.affiliation: Department of Radiology, University of Benin, Teaching Hospital, Benin, Nigeria.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Ighodaro
authors.affiliation: Department of Child Health, University of Benin, Teaching Hospital, Benin, Nigeria.
authors.forename: Yetunde-Isreal
authors.initials: YI
authors.lastname: Aina
authors.affiliation: Department of Maxillo-Facial, University of Benin, Teaching Hospital, Benin, Nigeria.
authors.forename: Anthony
authors.initials: A
authors.lastname: Osaguona
authors.affiliation: Department of Chemical Pathology, University of Benin, Teaching Hospital, Benin, Nigeria.
authors.forename: Osagie
authors.initials: O
authors.lastname: Idemudia
authors.affiliation: Department of Medical Microbiology, University of Benin, Teaching Hospital, Benin, Nigeria.
authors.forename: Osaretin
authors.initials: O
authors.lastname: Iyoha
authors.affiliation: Department of Child Health, Delta State University, Teaching Hospital, Abraka, Nigeria.
authors.forename: Okiroro
authors.initials: O
authors.lastname: Ighosewe
authors.affiliation: Department of Child Health, Sickle Cell Centre, Benin, Nigeria.
authors.forename: Dominic
authors.initials: D
authors.lastname: Osaghae
authors.affiliation: Department of Hematology, Basel University, Teaching Hospital, Basel, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Bucher
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000453:epidemiology / Q000628:therapy*; D002648:Child; D003906:Developing Countries; D006084:Graft Rejection / Q000188:drug therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D015995:Prevalence; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous
chemical_list: D007166:Immunosuppressive Agents