Sickle Cell Disease in Young and Old: A Time for Re-Evaluation
The care for patients with sickle cell disease has made significant advances in the last three decades and outlook has improved substantially for those with access to modern medical care. The majority of newborns in well-resourced countries will now survive to adulthood and overall median survival has recently been estimated to be in the late 50s and even the mid-to-late 60s in these countries. In contrast, more than 75 percent of newborns in sub-Saharan Africa do not even reach their fifth birthday. While prevention of complications and infection has been the mainstay for managing patients, the time has come for us to reevaluate our treatment strategy, to be more proactive in considering curative therapies early, before complications render the patients ineligible for these treatments. The longer survival forces us to rethink our treatment of the young, to address a most vulnerable period, and that is when children transition to adult care.
Dr. Mariane de Montalembert will discuss current strategies of comprehensive care for children in high-resource countries and compare with that accessible in developing ones. She will underline the need for a tight collaboration between proximity and expert health care providers, and the importance of increasing parents' and children' skills.
Dr. Jane Hankins will discuss approaches to engage adolescents and young adults to empower them as advocates of their own disorder, and how to improve survival during the period of transition to adult care. She will review new care delivery models of engaging youth and maintaining their retention in adult care, as well as national benchmarks against which transition programs should be compared with.
Dr. Swee Lay Thein will discuss clinical challenges that are becoming increasingly common in the management of older patients with sickle cell disease, due to cumulative disease complications related to the chronic vasculopathy, in addition to those related to aging. She will summarize the available evidence, discuss optimal strategies for management, and highlight current challenges and areas of uncertainty.
Mariane De Montalembert
Swee Lay Thein
Active, International, Emeritus, and Honorary Members
Associate, International Associate, Student, and Resident Members