How to treat Sickle Cell Anemia in India for Nigerian Patients

How to treat Sickle Cell Anemia in India for Nigerian Patients? We guide you to the best hospitals. Get full visa and medical support from GetWellGo.

How to treat Sickle Cell Anemia in India for Nigerian Patients

How to treat sickle cell anemia in India

Sickle Cell Anemia (SCA) is treated to lessen symptoms, avoid complications, and enhance the quality of life. Even though the disease does not have a universal cure, some medications may help considerably diminish the consequences of the disease. In other instances, bone marrow (stem cell) transplant is a cure.

How to treat sickle cell anemia: Main Goals

  • Avert sickle cell compilations
  • Treat anemia and pain
  • Prevent infections
  • Consider chronic issues
  • Enhance blood supply and circulation of oxygen

How to treat Sickle Cell Anemia: Standard Treatments

Medications

Hydroxyurea

  • It enhances the production of fetal hemoglobin (HbF) that diminishes the red cells sickling.
  • Less pain, less arrival to hospitals.
  • Unchecked pregnancy.

Painkillers 

  • Mild pain- acetaminophen or NSAIDs
  • Excruciating pain: opioids in medical care

Fibre supplements Boosters of flour-based supplements

  • Aids in the formation of red blood cells that are healthy

Antibiotics

  • Administered to children so as to prevent infections, particularly pneumonia

L-glutamine (Endari)

  • Lessens oxidative stress and crises rate

Voxelotor

  • Increased hemoglobin levels; reduced hemolysis

Crizanlizumab

  • Monoclonal antibody to lessen incidences of pain attack

Blood Transfusions

Used to:

  • Manage severe anemia
  • Prevent stroke (in children at high risk of stroke especially)
  • Operation planning
  • Complications in pregnancy management

Stem Cell or Bone Marrow Transplant

  • It is the only cure for SCA
  • Sickle cell-making bone marrow is replaced with healthy donor marrow
  • The most successful results are achieved in matched siblings donors
  • Potential complications include rejection, infection, and prolonged immune suppression.

Prevention Care and Lifestyle 

  • Stay hydrated
  • Avoid extremes of temperatures
  • Healthcare providers should treat infections without delay. 
  • Get routine vaccinations 
  • Frequent meetings with hematologist
  • Food (no over-exertion) and exercise

Observation and Treatment of Complications

  • Eye test: this is a test to identify damage to the retina
  • The tests of kidney and liver functions
  • Transcranial Doppler (TCD): in children - as an indicator of the risk of stroke
  • Cardiac tests: of pulmonary hypertension

New and Emerging Therapies

  • Gene therapy: the sickle gene is corrected using gene editing (e.g., CRISPR), in experimental trials. 
  • New drugs under development: attacks the molecular basis of sickling at its roots

Sickle cell anemia treatment India Nigerians

Sickle cell anemia (SCD) is a pathological disease of the blood which is hereditary in nature; the blood cells (red blood cells) are sickle-shaped and results in chronic anemia, painful attacks, infections, injuries to organs among other complications. Early diagnosis and management are a great improvement in terms of quality of life and minimization of mortality.

Treatment Options in India

India has various types of treatment of sickle cell disease, including supportive treatment as well as more complex curative treatments:

Normal Medical Management

The following treatment seeks to minimize the symptoms and complicate prevention:

  • Hydroxyurea treatment to reduce pain crisis and enhance blood count.
  • Frequent blood transfusion on demand.
  • Prevention of infection and control of pain.
  • Vaccines and antibiotics to prevent infections.
  • They are normally part of long-term outpatient programmes. 

Bone Marrow / Stem Cell Transplant (BMT/HSCT) -Possible Cure.

  • The nearest and possibly the only potential cure to the eligible SCD patients is at present allogeneic bone marrow or stem cell transplant.
  • This process involves the replacement of the defective marrow in the patient by a healthy stem cell of a match donor.
  • The success is determined by the ability to locate an appropriate HLA-matched donor and general patient health.
  • Most Indian hospitals do BMT treatment to international patients (including the Nigerians) and prior to the procedure there is genetic matching, tests, and consultations.

Newer and Extraneous Therapeutic Interventions

Some of the more sophisticated methods under study or pilot development are:

  • Gene editing (such as CRISPR-Cas9) cures to fix the underlying genetic mutation - which is now experimental.

Why should India be chosen to be treated?

The international patients, including the Nigerian ones, have started going to India because of:

  • Skilled hematologists and transplants.
  • Hospitals that have international patient services are globally accredited.
  • Reduced overall expenses as compared to the west.
  • Travel assistance, visa assistance and post-discharge assistance (some centres provide telemedicine assistance).

Bone marrow transplant sickle cell India Nigeria

The only form of treatment that has a potential to cure sickle cell anemia currently is bone marrow transplant (also referred to as hematopoietic stem cell transplant) so far particularly in children and young adults with severe forms of the disease. It entails the procedure of transplanting a defective bone marrow of a patient with healthy stem cells of a donor, preferably the complete match with a sibling donor. When matched family donor is present, the success rates are the greatest (80-90% in children), but with age, health, and the type of donor, the results are variable.

Blood transfusion sickle cell Nigeria patients India

Regular or emergency blood transfusion works to the benefit of people with sickle cell anemia:

  • Proliferate healthy red blood cells to enhance the supply of oxygen.
  • Therapy of severe anemia, acute chest syndrome or complications such as stroke.
  • Lessen the crisis of pain, the threat of organ injury.

Temporary alleviation of the condition should be provided in the short to medium term, as alternative treatment options (such as hydroxyurea or bone marrow transplant) are being considered.

There are various forms of transfusion methods which involve:

  • Simple (top-up) transfusion- Adding healthy donor blood.
  • Exchange transfusions - the replacement of sickled cells by normal red cells (better at lowering the percentages of sickle cell)

Factors Affecting Stem cell transplant sickle cell cost India

The following are the key determinants of the cost of a stem cell / bone marrow transplant in India in case of sickle cell disease:

Type of Transplant

  • Allogeneic (donor) transplant - the most common treatment used to treat sickle cell is much more costly than autologous (self) due to testing of donors, HLA typing, harvesting and storage of cells.

Within allogeneic:

  • Siblings matched donor transplants are less expensive.
  • The latter are more expensive (haploidentical/half-matched donor and unrelated donor) because of donor search and registry fees.

Hospital & Location

  • There are premium multispecialty hospitals in metros that are more expensive than the smaller cities or tier-2 centres.
  • Base costs tend to be higher in accredited transplant centres (NABH / JCI) that have dedicated BMT units and are better than other centres in terms of infection control and outcomes.

Length of stay and Level of care

  • Majority of the transplants entail weeks of seclusion in rooms with HEPA filters to avoid infections.
  • In case of complications (infection, graft-versus-host disease), ICU hospitalization and long-term hospital stay become additional costs.

Pre-Transplant Evaluation

Patients prior to transplant are subjected to:

  • HLA typing and donor compatibility.
  • Laboratory tests, x-rays, organ involvement.

These examinations are usually repeated and add up to the final bill particularly in the case of foreign patients.

Conditioning / Preparatory Treatment

  • Transplant is done after chemo or radiations to create space in the bone marrow to allow new cells.
  • The severity and time period of this conditioning phase is also dependent on the age of the patient, the illness severity, and the transplant protocol - which also influence the cost.

Post-Transplant Drugs and Observation

Patients normally require:

  • Antirejection immunosuppressants.
  • Antivirals, antibiotics, antifungals for prevention of infection.
  • Blood work, follow-up appointments. 

These recurring drugs and follow-ups may add significant expenses to the overall bill.

Patient Health & Age

  • Young and healthy patients are less complex and heal faster, which may reduce cost.
  • Older or comorbid patients (e.g. with organ failure) require more support and care, increasing costs. 

Donor Search & Harvest Logistics

  • In case a matched donor is not immediately available in the family, the hospital might consult the registries (Indian or International), this raises donor acquisition and transport fees.
  • Processing and storage expenses are also dependent upon the source of stem cells (bone marrow vs. peripheral blood vs. cord blood).

Sickle cell crisis management India Nigerians

A sickle cell crisis also known as a pain crisis happens when blood vessels are blocked by sickle-shaped red blood cells to a portion of the body causing a sudden, severe pain.

Here's what you need to know:

  • Pain can be located anywhere, but is most commonly in the chest, arms, legs, and back.
  • Pain may range from mild to the point of necessitating hospitalization. 

Crises may be triggered by:

  • Drying out. 
  • Infection
  • Cold weather or sudden change in temperature
  • Stress
  • High altitudes (less oxygen)

In a crisis, treatment is centered on:

  • Relieving pain (with medicines)
  • Hydration (IV fluids if necessary)
  • Treating infection
  • Oxygen therapy if breathing is impaired

Certain people have them regularly, but others may get them rarely. Treatment early can really reduce the frequency they occur! 

Pediatric sickle cell treatment India Nigerians

In children, sickle cell anemia usually starts to show its effects at about 5 to 6 months of age. Here's what occurs:

Early signs:

  • Swelling in the hands and feet (called dactylitis)
  • Irritability or fussiness from pain
  • Recurrent infections (due to spleen involvement)
  • Delayed puberty and slow growth

As they develop:

  • Children can suffer from painful sickle cell crises (painful attacks). 
  • They can become easily tired and weak (due to anemia)
  • They can get jaundice (yellowing of the skin and whites of the eyes).
  • They are at risk for serious complications including strokes and acute chest syndrome. 

Special treatment for children involves:

  • Regular visits
  • Prophylactic immunization for infections
  • Sensible to provide long-term antibiotics (sometimes) covering bacteria
  • Drink plenty of fluids and avoid extreme temperatures 
  • Medications such as hydroxyurea to minimize crises

Conclusion

In India, sickle cell disease transplantation using stem cell (bone marrow) is informed by the interaction of medical, institutional, and logistical issues such as the nature of the transplant, quality and adequacy of donor match, hospital facility and location, hospitalization duration, level of pre-conditioning therapy, post-transplant care, and overall patient health and risk factor. To the Nigerian patients, medical visas, travel, accommodation and follow up arrangements are other factors that determine the overall cost. Although India has well trained transplant facilities and a relatively cheap cost of care, close preparation, initial assessment of donors, and proper communication with hospitals regarding inclusions and exclusions in treatment packages is a critical step to properly calculate the cost and be assured of successful and safe treatment process.

Sickle cell treatment India GetWellGo Nigerians

GetWellGo is regarded as a leading supplier of healthcare services. We help our foreign clients choose the best treatment locations that suit their needs both financially and medically.

We offer:

  • Complete transparency
  • Fair costs.
  • 24 hour availability.
  • Medical E-visas
  • Online consultation from recognized Indian experts.
  • Assistance in selecting India's top hospitals for sickle cell treatment.
  • Expert doctors with a strong track record of success
  • Assistance during and after the course of treatment.
  • Language Support
  • Travel and Accommodation Services
  • Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
  • Local SIM Cards
  • Currency Exchange
  • Arranging Patient’s local food

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