Transplant of sibling's stem cells shows promise in sickle-cell fight

Ieshea Thomas, who has suffered from sickle cell anemia nearly all of her life, recently received a life-changing gift from her sister: stem cells.

Her sister Ivenus' donation of stem cells in November means Thomas' body is now able to produce normally shaped blood cells, instead of the sickle-shaped ones that cause all kinds of health problems for her. Thomas received the stem cell transplant as part of a clinical trial at the University of Illinois Hospital & Health Sciences System in Chicago.

Now, Thomas, 32, said she has become healthy enough to attend the graduation of her 14-year-old daughter, Miayatha, from junior high school.

"I'm glad I'm able to be here, to know her, to be her mom again. I'm so thankful for my sister," said Thomas, who lives in Chicago.

In the clinical trial, sickle cell anemia patients like Thomas are given stem cells that take over the function of producing red blood cells from their bone marrow.

The transplant addresses the central problem caused by the illness, which affects 90,000 to 100,000 Americans, according to the federal Centers for Disease Control. An estimated 1 in 12 African-Americans carry the genetic trait of sickle cell anemia.

"The only cure (for sickle cell anemia) is if you can change completely the blood of a patient. Sickle cell anemia is caused by a genetic disorder where the hemoglobin inside the red cells are abnormal. The red cells are not as flexible as usual. A sickle cell is the shape of red cells. They get stuck in small vessels, (causing) problems for the kidneys and liver, and very, very painful symptoms," said Dr. Damiano Rondelli, a professor of medicine and director of the blood and marrow transplant program at the U. of I. Hospital & Health Sciences System who performed Thomas' transplant.

Patients can have painful health crises for many years, and the sickle shape can affect any organ.

Although the preparation of a sickle cell anemia patient for a stem cell transplant usually includes chemotherapy to remove the bone marrow, the U. of I.'s clinical trial does not do so. Thomas is the first patient in the Midwest to receive the same protocol that researchers at the National Institutes of Health in the Washington, D.C., area used, which leaves out chemotherapy but instead includes medication that suppresses the immune system, and a small dose of radiation just before the stem cell transplant.

Once the stem cell is implanted, "monitoring (the patient) is very important. Initially, it's very often, to make sure they are safe, to guarantee they do not have rejection (of the transplant)," Rondelli said.

Initially, monitoring occurs every week, then decreases to every month, then to every three months, then to every six months, and then to once a year.

So far, the trial includes two completed transplants, and Rondelli is currently preparing to do a third one.

He is very optimistic about the trial. "This is the exciting part. We can in the Midwest offer this type of treatment to patients with sickle cell anemia," Rondelli said.

Patients with sickle cell anemia who are between the ages of 18 and 60 years are eligible for the transplant. At this point, eligible donors must be a full sibling of a patient and not have sickle cell anemia.

Both the timetable for the trial, and the number of participants that will ultimately participate, have not yet been determined, Rondelli said.

Thomas said the results so far in her care are "very exciting."

She is no longer taking pain medication, but is instead swallowing vitamins to help the transplant continue to work well in her body.

"I have more free time, so I can get a regular job or go to school," Thomas said. "I don't have to worry about being in the hospital every day. I can think about not being sick, about what it's like to wake up and not be hurt, to not be in pain. I have to be (optimistic). Coming from where I was, there's nowhere to go but up."

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