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Case Reports in Hematology
Volume 2017 (2017), Article ID 8394732, 5 pages
https://doi.org/10.1155/2017/8394732
Case Report

A Child as a Donor for Hematopoietic Stem Cell Transplantation: Bioethical Justification—A Case Study on Sickle Cell Disease

1Oncology, Hematology, and Bioethical Committee, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
2Oncology and Hematology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
3Hematology and Bone Marrow Transplantation, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
4Bioethical Committee, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil

Correspondence should be addressed to Andrea Z. Pereira; moc.liamtoh@arierep_paerdna

Received 21 October 2016; Revised 30 January 2017; Accepted 13 February 2017; Published 23 February 2017

Academic Editor: Kostas Konstantopoulos

Copyright © 2017 Andrea Z. Pereira et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hematopoietic stem cell transplantation (HSCT) is an important treatment option for children with severe and refractory sickle cell disease (SCD) with debilitating clinical complications. HSCT with cells from the bone marrow of a HLA-identical sibling used in SCD has a low mortality risk, high cure rate, and high event-free survival rate after a median follow-up of 5-6 years. However, matched donors are found in only about 20% of the patients. A boy aged 8 years with SCD had a sister, <2 years old, a fully compatible donor. The boy met all eligibility criteria to undergo HSCT, and he was suffering from cognitive and neurologic impairment due to ischemic events. A Bioethical Committee jointly discussed the ethical issues on this case after a pediatric evaluation released the very young sister for donation. The justification was that the sister would benefit from the donation too because of the greater likelihood of survival and cure and less suffering of her brother. The parents were informed about the risks and benefits for both children, and the family was psychologically evaluated. After their consent, HSCT was performed and the patient is cured from SCD. The complication for the donor was the need for blood transfusion.