Also, in sickle cell disease, children often have less organ damage from their sickle cell disease, which improves their chances of survival. Patients chosen for bone marrow transplantation must be carefully selected. Bone marrow transplantation is recommended when the disease being treated carries a high probability of death. Examples include malignancies, such as certain forms of childhood leukemia and lymphoma. Bone marrow transplantation is also used in some diseases that are not frankly malignant, but where a predictable progression to illness and death occurs.
Some patients have nearly no symptoms.
Others are severely incapacitated. The nature of sickle cell disease in a particular child often is not clear until the child has suffered severe injury on the one hand, or lived a relatively normal childhood on the other. The risks of bone marrow transplantation are higher in older children and adults. Further, people who have suffered severe problems from their sickle cell disease, such as advanced kidney disease, are less likely to survive a bone marrow transplantation procedure. This is the difficulty with bone marrow transplantation in sickle cell disease.