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One in every 150 Jamaican babies will be born with sickle cell disease. About 10% of Jamaicans wear the S.
Remedies are available, but they are expensive. Sickle cell disease is a group of disorders that affect the hemoglobin – the molecule in red blood cells that provides oxygen to whole body cells.
Dr. Monika Asnani, senior lecturer at the University of the West Indies (UWI) Depotocytosis Unit, explained in an interview with Jamaica Observer last Thursday, in anticipation of the days annual UWI research, to be held from February 6 to 8. Bone marrow transplantation and gene therapy can treat this disease that could affect 0.7% of the population.
"There are treatments for the bone marrow transplant that is not yet available in the Caribbean, and [gene] therapy [which] continues to be investigated. With bone marrow transplant, one of the most important things you need is someone who fits you.
"Your bone marrow has to be a match. At the present time, we find that no less than 15% of people with sickle cell disease would be tied. So, it's a huge thing.
"After that, the bone marrow of the sickle cell patient should be totally destroyed by powerful treatments, such as chemotherapy, to be able to use the corresponding bone marrow," said Dr. Asnani, adding that in the United States, treatment was free. for citizens, the government spends nearly $ 200,000 for each patient.
For gene therapy, said Dr. Asnani, since the procedure is still experimental and not available for the Caribbean, except for areas away from large colonies, it costs hundreds of thousands of dollars to access this treatment.
"I do not know if I would be wrong to say that the team would have spent more than a million US dollars for the treatment of the first person. When there is an investigation, there are many details to try and we continue to learn. But if a company supports this vector and the product easily, this could happen in years.
"For gene therapy, your transplant comes from your cell. So, if I had sickle cell disease, my bone marrow is removed and a gene converted, or a corrective gene is inserted and my bone marrow is returned to me.
"Why does a body need a perfect fit, that is, in the way our body is made, we reject the alien things. So, if I want to get a bone marrow from my blood sister, there is a possibility of rejecting it.
"It avoids having to put another person under treatment, to take his bone marrow and insert it. The most important thing is that you are dealing with one person. In gene therapy, your own cells, a corrective gene is inserted and returned to you.
"When I started the gene therapy treatment of my first patient, it was amazing. If this succeeds and we all hope – scientists, doctors, patients and families of health care providers – that it will be so, it is a treatment that is more likely to happen. To be adopted in areas of the world where sickle cell disease is the strongest. burden – sub-Saharan Africa
At the same time, Dr. Asnani pointed out that the costs incurred by her patients in places where insurance was not available to them had proved exorbitant.
"We do a lot to manage the disease. If we can have you when you're a baby and we work with families, that would be good. Our patients are living longer, but their lifespan is still about 20 years less than in most countries where sickle cell disease is, "she noted.
Dr. Asnani suggested that establishing bone marrow therapy and gene therapy therapy in the Caribbean could cost "a fortune".
"We would need hematologists who would be willing to perform a bone marrow transplant on our patients. This requires huge editing. You can imagine that when you receive chemotherapy to destroy your existing bone marrow, you need extremely sterile conditions, and all of this contributes to making this cost quite high.
"I have no doubt we have the expertise here in Jamaica. It may be better to switch to gene therapy in the next few years because we hope this process will be cheaper, "she added.
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