Summary of key potential harms of HLA-identical sibling HSCT and SCD
| Harm . | HSCT . | SCD . |
|---|---|---|
| Death | Low risk of dying from transplant complication | Very low risk of dying as a child with current supportive care, high risk of dying prematurely as an adult |
| Infection | Severely immunocompromised for weeks post-transplant | Defective or absent splenic function |
| Acute complication | Mucositis, hair loss, veno-occlusive disease, cerebral hemorrhage, posterior reversible encephalopathy syndrome | Vaso-occlusive crisis, acute chest syndrome, cholecystitis, priapism, splenic sequestration, aplastic crisis, stroke |
| Chronic complication | Graft-versus-host disease | Chronic pain, avascular necrosis, progressive multi-organ damage (retinopathy, kidney dysfunction, pulmonary hypertension) |
| Reproductive problems | Possible secondary to gonadotoxic conditioning | Possible secondary to organ damage (men: erectile dysfunction; women: pregnancy complications) or hydroxyurea therapy |
| Social | Intense short-term burden due to transplant hospitalization and care post-transplant | Life-long burden of chronic disease |
| Harm . | HSCT . | SCD . |
|---|---|---|
| Death | Low risk of dying from transplant complication | Very low risk of dying as a child with current supportive care, high risk of dying prematurely as an adult |
| Infection | Severely immunocompromised for weeks post-transplant | Defective or absent splenic function |
| Acute complication | Mucositis, hair loss, veno-occlusive disease, cerebral hemorrhage, posterior reversible encephalopathy syndrome | Vaso-occlusive crisis, acute chest syndrome, cholecystitis, priapism, splenic sequestration, aplastic crisis, stroke |
| Chronic complication | Graft-versus-host disease | Chronic pain, avascular necrosis, progressive multi-organ damage (retinopathy, kidney dysfunction, pulmonary hypertension) |
| Reproductive problems | Possible secondary to gonadotoxic conditioning | Possible secondary to organ damage (men: erectile dysfunction; women: pregnancy complications) or hydroxyurea therapy |
| Social | Intense short-term burden due to transplant hospitalization and care post-transplant | Life-long burden of chronic disease |