Gender
All
Age Group
2 Years to 25 Years
Accepting Healthy Volunteers
No
Inclusion Criteria:
- Hemoglobin SS, SC, S-β0 Thalassemia, or SO-Arab Sickle Cell Disease
- Between the ages of 2 and 25 years (Stage 1: 10-25 years; Stage II: 2-25 years)
- Lack a fully matched family donor or fully matched unrelated donor register in the
National Marrow Donor Program
- Partially-matched family member with hemoglobin AA (normal) or hemoglobin AS (sickle
trait) phenotype
- SCD with Severe Phenotype, defined by the following criteria: Neurologic
manifestations of sickle disease including cerebral vascular accident (CVA),
transient ischemic event (TIA) or abnormal MRI findings suggestive of silent
infarct; Two or more episodes of acute chest syndrome (ACS) requiring admission for
transfusional or respiratory support including supplemental oxygen within [two
years] of enrollment in study despite hydroxyurea therapy. Patients who cannot
tolerate hydroxyurea and who experience multiple episodes of ACS will also be
eligible; History of severe vaso-occlusive (VOC) disease requiring hospitalization
and intravenous narcotics on 3 or more occasions per year over the two years prior
to enrollment despite hydroxyurea therapy. Patients who cannot tolerate hydroxyurea
and who experience multiple episodes of VOC will also be eligible; Other severe
phenotype as evidenced by end organ dysfunction related to sickle cell disease.
Exclusion Criteria:
- Karnofsky or Lansky score < 60%
- Acute hepatitis or evidence of moderate or severe portal fibrosis on biopsy. (Biopsy
will be obtained if patient has been on chronic transfusion therapy > 6 months or
has a ferritin > 1000 ng/ml) or AST or ALT >5 times the upper limit of normal
- Severe renal impairment (as evidenced by creatinine clearance of <50ml/minute
glomerular filtration rate (GFR) < 50% predicted normal)
- Cardiac function that demonstrates shortening fraction less than 26% by cardiac
echocardiogram or pulmonary hypertension.
- Pregnant Female.
- Lactating female.
- Pulmonary function with baseline O2 saturation <85% or Diffusing Capacity for Carbon
Monoxide (DLCO) on pulmonary function testing (PFT) with a DLCO <40%.