Expanding access to life-changing sickle cell treatment

The paediatric sickle cell apheresis service at Evelina London Children's Hospital has expanded to offer the important treatment to a larger number of patients.

Sickle cell turns normal red blood cells into C-shaped or 'sickle' shaped cells. These misshapen cells do not flow through the body as easily as healthy cells. For people with sickle cell, this can cause painful episodes called sickle cell crises, an increased risk of serious infections, and anaemia which can cause tiredness and shortness of breath.

Apheresis is a procedure that can be used to treat sickle cell. It removes the sickled red blood cells and replaces them with healthy donated ones. This is also known as red blood cell exchange transfusion.

This treatment is an integral part of managing sickle cell for eligible patients. At Evelina London, apheresis can be offered to children as young as 5 years old and weighing as little as 25 kilograms.

More staff are now trained to deliver this specialist service, meaning up to 40 more patients could benefit from treatment each year. Extended appointment times until 6pm also make it easier for families to fit treatment around school and daily life.

Compared with a simple blood transfusion, apheresis offers better control of sickle cell levels in the blood. It can help reduce the risk of serious complications, including stroke, and is faster, making it more practical for children and their families. It usually takes between 1.5 to 2 hours to complete, compared to 2 to 5 hours for a simple transfusion. Apheresis also reduces the risk of iron build-up in the body, as blood is removed during the process, avoiding iron accumulation.

Elizabeth, 16, has been receiving apheresis at Evelina London to treat her sickle cell anaemia for almost 2 years. She said:

Apheresis has changed my life. The transfusions make me feel like I don’t have sickle cell anymore. They have helped me in so many ways and made me feel healthier. I would definitely recommend them to anyone who is dealing with severe pain.

Dr Samah Babiker, consultant paediatric haematologist and clinical lead for the service, said: "I am so pleased that the service has expanded. The number of children and young people with sickle cell is growing, and so is the need for advanced clinical treatments like apheresis.

Making this service more widely available will help improve access to care and reduce health inequalities for families in our local area and across the south east of England. It also means children can spend less time in hospital and more time at school and with their families.

"We are now looking to train even more colleagues so that we can also provide appointments on Saturdays, giving families greater choice and flexibility that fits around daily life."