1
|
Lugthart S, Ginete C, Kuona P, Brito M, Inusa BPD. An update review of new therapies in sickle cell disease: the prospects for drug combinations. Expert Opin Pharmacother 2024; 25:157-170. [PMID: 38344818 DOI: 10.1080/14656566.2024.2317336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/07/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Sickle cell disease (SCD) is an inherited disorder characterised by polymerisation of deoxygenated haemoglobin S and microvascular obstruction. The cardinal feature is generalised pain referred to as vaso-occlusive crises (VOC), multi-organ damage and premature death. SCD is the most prevalent inherited life-threatening disorders in the world and over 85% of world's 400,000 annual births occur low-and-middle-income countries. Hydroxyurea remained the only approved disease modifying therapy (1998) until the FDA approved L-glutamine (2017), Crizanlizumab and Voxelotor (2019) and gene therapies (Exa-cel and Lovo-cel, 2023). AREAS COVERED Clinical trials performed in the last 10 years (November 2013 - November 2023) were selected for the review. They were divided according to the mechanisms of drug action. The following pubmed central search terms [sickle cell disease] or [sickle cell anaemia] Hydroxycarbamide/ Hydroxyurea, L-Glutamine, Voxelotor, Crizanlizumab, Mitapivat, Etavopivat, gene therapy, haematopoietic stem cell transplantation, and combination therapy. EXPERT OPINION We recommend future trials of combination therapies for specific complications such as VOCs, chronic pain and renal impairment as well as personalised medicine approach based on phenotype and patient characteristics. Following recent approval of gene therapy for SCD, the challenge is addressing the role of shared decision-making with families, global access and affordability.
Collapse
Affiliation(s)
- Sanne Lugthart
- Haematology department, University Hospitals of Bristol and Weston Foundation Trust, Bristol, UK
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, UK
| | - Catarina Ginete
- Health and Technology Research Center, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Portugal
| | - Patience Kuona
- Child, Adolescent and Women's Health Department, University of Zimbabwe Faculty of Medicine and Health Sciences, Harare, Zimbabwe
| | - Miguel Brito
- Health and Technology Research Center, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Portugal
| | - Baba Psalm Duniya Inusa
- Paediatric Haematology, Evelina London, Guy's and St Thomas NHS Foundation Trust, London
- Women's and Children Academic health, Life Sciences and Medicine, King's College London, London
| |
Collapse
|
2
|
Pellegrini M, Chakravorty S, Del Mar Manu Pereira M, Gulbis B, Gilmour-Hamilton C, Hayes S, de Montalembert M, Inusa BPD, Colombatti R, Roy NB. Sickle cell disease: embedding patient participation into an international conference can transform the role of lived experience. Orphanet J Rare Dis 2023; 18:341. [PMID: 37908000 PMCID: PMC10619309 DOI: 10.1186/s13023-023-02951-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 10/10/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Sickle cell disease (SCD) is an inherited chronic life-threatening disorder with increasing prevalence in Europe. People living with SCD in Europe mainly belong to vulnerable minorities, have a lower level of health education and suffer from isolation compared to those living with other chronic conditions. As a result, SCD patients are much less likely to partner in the design of research related to their condition and are limited in their ability to influence the research agenda. Aiming to increase the influence of patient voice in the development of SCD-related research, we set out to develop patient centered actions in the frame of International Scientific Conferences in collaboration with the ERN-EuroBloodNet, Oxford Blood Group, Annual Sickle Cell Disease and Thalassaemia Conference (ASCAT), the European Hematology Association and the British Society of Hematology. RESULTS Two events were organized: a one-day research prioritization workshop and a series of education sessions based on topics chosen by SCD patients and their families. Methodology and outcomes were analyzed in terms of influence on scientific, medical and patient communities. CONCLUSION The ERN-EuroBloodNet workshops with patients at annual ASCAT conferences have provided an opportunity to enhance patient experience and empowerment in SCD in Europe, producing benefits for patients, caregivers, patient associations and health professionals. Future work should focus on delivering the research questions identified at this workshop and the opportunities to share information for patient education.
Collapse
Affiliation(s)
- Mariangela Pellegrini
- European Reference Network on Rare Hematological Disease, the ERN-EuroBloodNets, Hôpitaux de Paris, Hôpital Saint Louis, Paris, France.
| | | | - Maria Del Mar Manu Pereira
- European Reference Network on Rare Hematological Diseases, the ERN-EuroBloodNet, Vall d'Hebron Research Institute/Vall d'Hebron University Hospital, Barcelona, Spain
| | - Beatrice Gulbis
- European Reference Network on Rare Hematological Diseases, the ERN-EuroBloodNet, Hôpital Erasme/LHUB-ULB, Brussels, Belgium
| | | | - Sandy Hayes
- Oxford University Hospitals NHS Trust, Oxford, England
| | - Mariane de Montalembert
- European Reference Network On Rare Hematological Diseases, the ERN-EuroBloodNet, Hôpitaux de Paris, Hôpital Necker, Paris, France
| | - Baba Psalm Duniya Inusa
- Paediatric Haematology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Raffaella Colombatti
- European Network of Rare Hematological Diseases, the ERN-EuroBloodNetPediatric Hematology Oncology Unit, Department of Women's and Child's Health, University of Padova, Padua, Italy
| | - Noémi Ba Roy
- Oxford University Hospitals NHS Trust, Oxford, England
| |
Collapse
|
3
|
Costa FF, Montalembert M, Anderson A, Jastaniah W, Kunz JB, Odame I, Beaubrun A, Montealegre-Golcher F, Lartey B, Inusa BPD. PERSPECTIVAS DOS MÉDICOS BRASILEIROS SOBRE A DOENÇA FALCIFORME E SEU TRATAMENTO: RESULTADOS DA PESQUISA DE CONHECIMENTO, PERSPECTIVAS E EXPERIÊNCIAS EM SAÚDE DA DOENÇA FALCIFORME (SICKLE CELL HEALTH AWARENESS, PERSPECTIVES AND EXPERIENCES, SHAPE). Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
4
|
Costa FF, Odame I, Anderson A, Inusa BPD, Jastaniah W, Kunz JB, Soares MZ, Montealegre-Golcher F, Lartey B, Montalembert M. IMPACTO DA DOENÇA FALCIFORME NA QUALIDADE DE VIDA DE PACIENTES BRASILEIROS E SEUS CUIDADORES: ACHADOS DA PESQUISA DE PERCEPÇÃO, PERSPECTIVAS E EXPERIÊNCIAS EM SAÚDE FALCIFORME. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
5
|
Inusa BPD, Liguoro I, Tayo B, Booth C, Turner C, Dalton NR. Reliability of different estimated glomerular filtration rate as measures of renal function in children with sickle cell disease. Blood Cells Mol Dis 2021; 91:102590. [PMID: 34256313 DOI: 10.1016/j.bcmd.2021.102590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/12/2021] [Accepted: 06/24/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND There is no reliable marker for detecting early renal disease in early children with sickle cell disease (SCD). Estimation of glomerular filtration rate (eGFR) as derived from the height/plasma creatinine formula is dependent on the accuracy of the creatinine analytical method used. The aim of this study was to evaluate different equations for eGFR. METHODS Children aged 5-16 years recruited. mGFR was obtained using plasma disappearance of Inutest/Iohexol, serum creatinine (SCr) was measured either by standard laboratory method or by tandem mass spectrometry (MSMS). Estimated GFR was then calculated either by "Bedside Schwartz method" or by the full-age spectrum (FAS) equation. FINDINGS A total of 79 patients (mean age 9.8 ± 4.0 years). A revised eGFR constant was calculated for Schwartz equation from the slope of the plot of height/plasma creatinine versus mGFR. Mean values for mGFR (132.7 ± 32.1 ml/min/1.73m2) and eGFR methods compared: eGFR from standard SCr was significantly higher (144.2 ± 37.3 ml/min/1.73m2, p = 0.008). The MSMS eGFR showed the lowest SD (SD = 27.5), while both FAS eGFR and FAS-height eGFR showed the highest correlation coefficient (r = 0.67). INTERPRETATION eGFR calculation based on height and SCr determined with MSMS traceable creatinine is more reliable than Schwartz formula using jaffe/enzymatic methods in SCD children.
Collapse
Affiliation(s)
- Baba Psalm Duniya Inusa
- Paediatric Haematology, Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK.
| | - Ilaria Liguoro
- Department of Medicine, Division of Pediatrics, University of Udine, Italy
| | - Bamidele Tayo
- Department of Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, USA
| | - Caroline Booth
- Department of Nephrology, Evelina London Children's Hospital, Guy's and St Thomas NHS Foundation Trust, United Kingdom
| | - Charles Turner
- WellChild Laboratory, Evelina London Children's Hospital, Guy's and St Thomas NHS Foundation Trust, United Kingdom
| | - Neil R Dalton
- WellChild Laboratory, Evelina London Children's Hospital, Guy's and St Thomas NHS Foundation Trust, United Kingdom
| |
Collapse
|
6
|
Inusa BPD, Casale M, Campbell A, Archer N. Will the changing therapeutic landscape meet the needs of patients with sickle cell disease? Lancet Haematol 2021; 8:e306-e307. [PMID: 33838114 DOI: 10.1016/s2352-3026(21)00098-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Baba Psalm Duniya Inusa
- Paediatric Haemotology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London SE1 7EH, UK.
| | - Maddalena Casale
- Università degli Studi della Campania Luigi Vanvitelli, Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica Napoli, Naples, Italy
| | - Andrew Campbell
- Department of Hematology, Children's National Hospital, Washington, DC, USA; Children's National Hospital, George Washington University School of Medicine, Fredericksburg, VA, USA
| | - Natasha Archer
- Department of Pediatric Hematology and Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
7
|
Inusa BPD, Jacob E, Dogara L, Anie KA. Racial inequalities in access to care for young people living with pain due to sickle cell disease. Lancet Child Adolesc Health 2020; 5:7-9. [PMID: 33065000 DOI: 10.1016/s2352-4642(20)30318-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 09/17/2020] [Accepted: 09/18/2020] [Indexed: 01/18/2023]
Affiliation(s)
- Baba Psalm Duniya Inusa
- Paediatric Haematology, Evelina London Children's Hospital, Guy's and St Thomas NHS Foundation Trust, London SE1 7EH, UK; Women's and Children's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK.
| | - Eufemia Jacob
- Department of Paediatric Haematology, UCLA School of Nursing, Los Angeles, CA, USA
| | - Livingstone Dogara
- Department of Haematology, Faculty of Basic Clinical Sciences, Kaduna State University College of Medicine, Kaduna, Nigeria
| | - Kofi A Anie
- Haematology and Sickle Cell Centre, Central Middlesex Hospital, London North West University Healthcare NHS Trust, London, UK; Faculty of Medicine, Imperial College London, London, UK
| |
Collapse
|
8
|
Inusa BPD, Stewart CE, Mathurin-Charles S, Porter J, Hsu LLY, Atoyebi W, De Montalembert M, Diaku-Akinwumi I, Akinola NO, Andemariam B, Abboud MR, Treadwell M. Paediatric to adult transition care for patients with sickle cell disease: a global perspective. Lancet Haematol 2020; 7:e329-e341. [PMID: 32220342 DOI: 10.1016/s2352-3026(20)30036-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 01/26/2020] [Accepted: 01/28/2020] [Indexed: 01/19/2023]
Abstract
Sickle cell disease is a life-threatening inherited condition designated as a public health priority by WHO. Increased longevity of patients with sickle cell disease in high-income, middle-income, and low-income countries present unprecedented challenges for all settings; however, a globally standardised solution for patient transition from paediatric to adult sickle cell disease health care is unlikely to address the challenges. We established a task force of experts from a multicountry (the USA, Europe, Middle East, and Africa) consortium. We combined themes from the literature with viewpoints from members of the task force and invited experts to provide a global overview of transition care practice, highlighting barriers to effective transition care and provide baseline recommendations that can be adapted to local needs. We highlighted priorities to consider for any young person with sickle cell disease transitioning from paediatric to adult health care: skills transfer, increasing self-efficacy, coordination, knowledge transfer, linking to adult services, and evaluating readiness (the SICKLE recommendations). These recommendations aim to ensure appropriate benchmarking of transition programming, but multisite prospective studies are needed to address this growing public health need.
Collapse
Affiliation(s)
- Baba Psalm Duniya Inusa
- Department of Paediatric Haematology, Evelina London Children's Hospital, Guy's and St Thomas NHS Foundation Trust, London, UK.
| | | | | | - Jerlym Porter
- St Jude Children's Research Hospital, Memphis, TN, USA
| | - Lewis Li-Yen Hsu
- Comprehensive Sickle Cell Center, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Wale Atoyebi
- Cancer and Haematology Centre, Churchill Hospital, Oxford, UK
| | - Mariane De Montalembert
- Reference Center for Sickle Cell Disease, Hôpital Necker-Enfants malades, Assistance Publique - Hôpitaux de Paris, Université Paris Descartes, Paris France; Labex GR-Ex, Paris, France
| | | | - Norah O Akinola
- Department of Haematology and Immunology, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Biree Andemariam
- New England Sickle Cell Institute, Neag Comprehensive Cancer Center, University of Connecticut Health, Farmington, CT, USA
| | - Miguel Raul Abboud
- Department of Pediatric Hematology Oncology, American University Beirut, American University Beirut, Lebanon
| | - Marsha Treadwell
- University of California San Francisco Benioff Children's Hospital Oakland, Oakland, California, USA
| |
Collapse
|
9
|
Inusa BPD, Colombatti R, Rees DC, Heeney MM, Hoppe CC, Ogutu B, Hassab HM, Zhou C, Yao S, Brown PB, Heath LE, Jakubowski JA, Abboud MR. Geographic Differences in Phenotype and Treatment of Children with Sickle Cell Anemia from the Multinational DOVE Study. J Clin Med 2019; 8:jcm8112009. [PMID: 31744266 PMCID: PMC6912763 DOI: 10.3390/jcm8112009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 11/07/2019] [Accepted: 11/10/2019] [Indexed: 11/30/2022] Open
Abstract
Background: DOVE (Determining Effects of Platelet Inhibition on Vaso-Occlusive Events) was a Phase 3, randomized, double-blind, placebo-controlled study conducted in children with sickle cell anemia at 51 sites in 13 countries across four continents. Procedure: Data from DOVE were assessed for regional differences in subject phenotype and treatment. Demographics, baseline clinical and laboratory data, hydroxyurea (HU) use, vaso-occlusive crisis (VOCs; composite endpoint of painful crisis or acute chest syndrome (ACS)), serious adverse events (SAEs), hospitalization, and treatments were compared across the Americas, Europe, North Africa/Middle East, and Sub-Saharan Africa (SSA). Results: Race, body mass index, and blood pressures differed by region. Pre-enrollment VOCs were highest in the Americas. For subjects not on HU, baseline hemoglobin was lowest in SSA; reticulocyte count was lowest in the Americas. Within SSA, Kenya subjects presented higher baseline hemolysis. Painful crisis was the most common SAE, followed by ACS in the Americas and infections in other regions. VOC rate and percentage of VOC hospitalizations were highest in Europe. Regardless of region, most VOCs were treated with analgesics; approximately half were treated with intravenous fluids. The proportion of VOC-related transfusions was greatest in Europe. Lengths of hospital stay were similar across regions. Conclusions: Overall differences in SAEs and hospitalization for VOCs may be due to cultural diversities, resource utilization, disease severity, or a combination of factors. These data are of importance for the planning of future trials in SCA in a multinational setting.
Collapse
Affiliation(s)
- Baba Psalm Duniya Inusa
- Evelina Children’s Hospital, and Guy’s and St. Thomas’ Hospital, London SE1 7EH, UK
- Women and Children’s Health, Faculty of Life Sciences & Medicine, King’s College, London SE1 7EH, UK
- Correspondence: ; Tel.: +44-791-959-7783; Fax: +44-207-188-4612
| | - Raffaella Colombatti
- Clinic of Pediatric Hematology-Oncology, Azienda Ospedaliera-University of Padua, Padua 35129, Italy;
| | - David C. Rees
- Department of Paediatric Haematology, King’s College London, King’s College Hospital, Denmark Hill, London SE5 8RZ, UK;
| | - Matthew M. Heeney
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, MA 02115, USA;
| | - Carolyn C. Hoppe
- UCSF Benioff Children’s Hospital Oakland, Oakland, CA 94609, USA;
| | - Bernhards Ogutu
- U.S. Army Medical Research Unit-Kenya, Centre for Clinical Research, Kenya Medical Research Institute, Kisumu 00200, Kenya;
| | - Hoda M. Hassab
- Pediatric Department and Clinical Research Center, Faculty of Medicine, Alexandria University, Alexandria 21500, Egypt;
| | - Chunmei Zhou
- Eli Lilly and Company, Indianapolis, IN 46285, USA; (C.Z.); (S.Y.); (P.B.B.); (L.E.H.); (J.A.J.)
| | - Suqin Yao
- Eli Lilly and Company, Indianapolis, IN 46285, USA; (C.Z.); (S.Y.); (P.B.B.); (L.E.H.); (J.A.J.)
| | - Patricia B. Brown
- Eli Lilly and Company, Indianapolis, IN 46285, USA; (C.Z.); (S.Y.); (P.B.B.); (L.E.H.); (J.A.J.)
| | - Lori E. Heath
- Eli Lilly and Company, Indianapolis, IN 46285, USA; (C.Z.); (S.Y.); (P.B.B.); (L.E.H.); (J.A.J.)
| | - Joseph A. Jakubowski
- Eli Lilly and Company, Indianapolis, IN 46285, USA; (C.Z.); (S.Y.); (P.B.B.); (L.E.H.); (J.A.J.)
| | - Miguel R. Abboud
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut 11-0236, Lebanon;
| |
Collapse
|
10
|
Inusa BPD, Wale A, Hassan AA, Idhate T, Dogara L, Ijei I, Qin Y, Anie K, Lawson JO, Hsu L. Low-dose hydroxycarbamide therapy may offer similar benefit as maximum tolerated dose for children and young adults with sickle cell disease in low-middle-income settings. F1000Res 2018; 7. [PMID: 30228870 PMCID: PMC6124375 DOI: 10.12688/f1000research.14589.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/23/2018] [Indexed: 12/14/2022] Open
Abstract
The multiple clinical benefits of hydroxycarbamide in sickle cell disease are supported by a large body of evidence. The maximum tolerated dose (MTD) is the regimen recommended by guidelines from a panel of National Heart, Lung, and Blood Institute (NHLBI) experts, but other dosage regimens have been used in babies (BABY-HUG) 9 to 18 months old (20 mg/kg per day) and developing countries such as India (10 mg/kg per day); however, there has been no direct comparison of the efficacy, effectiveness, or cost-effectiveness of these different regimens. The purpose of this review was to investigate the current situation with various hydroxycarbamide regimens with particular relevance to low-middle-income countries. In regard to methodology, a literature review was undertaken by using multiple databases in PubMed and Google and the search terms included sickle cell disease, hydroxyurea, hydroxycarbamide, sickle cell anaemia, low-middle-income countries, Sub-Saharan Africa, and India. Although MTD regimens have been widely used in research, especially within North America, clinical trials elsewhere tend to use fixed-dose regimens. In a survey of haematologists across Europe and Africa, 60% (75% response rate) did not use the MTD regimen for hydroxycarbamide treatment of sickle cell disease. The recommendations are (1) for practical purposes to commence using fixed-dose hydroxycarbamide in line with BABY-HUG recommendations and then (2) to consider or propose a trial comparing MTD escalation with various fixed doses and to include as end points health-related quality of life, haemoglobin F levels, adherence, and cost-effectiveness.
Collapse
Affiliation(s)
- Baba Psalm Duniya Inusa
- Paediatric Haematology, Evelina London Children's Hospital, Guy's and St Thomas NHS Foundation Trust, London, UK
| | - Atoyebi Wale
- Department of Haematology, Oxford University Teaching Hospital, Oxford, UK
| | - Abdul Aziz Hassan
- Department of Haematology & Blood Transfusion, Faculty of Basic Clinical Sciences, College of Health Sciences, Ahmadu Bello University & ABU Teaching Hospital, Zaria, Nigeria
| | - Tushar Idhate
- Division of Paediatric Haematology and Oncology, Department of Paediatrics, Mahatma Gandhi Mission Medical College and Hospital, Aurangabad, India
| | - Livingstone Dogara
- Haematology and Blood Transfusion, Faculty of Clinical Sciences, Kaduna State University College of Medicine, Kaduna State University, Kaduna, Nigeria
| | - Ifeoma Ijei
- Haematology and Blood Transfusion, Faculty of Clinical Sciences, Kaduna State University College of Medicine, Kaduna State University, Kaduna, Nigeria
| | - Yewen Qin
- Paediatrics Department, University Hospital, Lewisham and Greenwich NHS Trust, King's College London, London, UK
| | - Kofi Anie
- Haematology and Sickle Cell Centre, London North West University Healthcare NHS Trust, London, UK.,Imperial College London, London, UK
| | | | - Lewis Hsu
- Pediatric Sickle Cell Center, University of Illinois at Chicago, Chicago, Illinois, USA
| |
Collapse
|