Elegibilidade para transplante de células-tronco hematopoiéticas em pacientes falcêmicos de um Hospital Universitário no Nordeste do Brasil

Abstract

Background - Sickle cell disease is the most prevalent hemoglobinopathy in the world. For 108 years, researchers have been challenging the search for a curative treatment, such as hematopoietic stem cell transplantation (HSCT), which reduces the morbidity of the pathology and offends its patients and life expectancy that is closer to those of non- hematopoietic stem cells patients. This study aims to analyze eligibility for HSCT in patients with sickle cell disease Methods - It is a descriptive, historical cohort study. A chart review was performed. Eligibility was defined among the criteria for HSCT, established by the National Commission for the Incorporation of Technologies in SUS (CONITEC) in 2015 and Joint Ordinance No. 5 / SAS / MS of February 19, 2018, in patients with sickle cell disease ( genotype SS, S / β- thalassemia, SC), attended at the University Hospital of the Federal University of Sergipe. Results - The sample is composed of 326 sickle cell patients. Of these, 270 (82.8%) had SS, 45 (13.8%) SC, 1 (0.3%) SD and 10 (3.1%) Sβ. Among SS and Sβ patients, 125 (44.6%) patients had an indication for HSCT, of which 124 (99.2%) were SS and 1 (0.8%) were Sβ. The mean age was 13.6 years, 36% were in the use of hydroxyurea and 8.8% in the hypertransfusional regime. The reasons for indication of transplantation in the sample are alloimmunizations 5 (4%), cerebrovascular accident (CVA) 18 (14.4%), vaso-occlusive crises (CVO) 45 (36%), more than one indication 40 %), osteonecrosis 4 (3.2%), priapism 7 (5.6%) and acute thoracic syndrome (STA) 6 (4.8%). Conclusion – In a sample of 280 patients with SS and Sβ, 44.6% are eligible for transplantation, 32% of which have two or more criteria for performing the procedure.