Lagos, Nigeria, September 20th, 2024—The Lagos University Teaching Hospital
(LUTH), in partnership with the Sickle Cell Foundation Nigeria (SCFN), has worked for
several years to establish a high-quality, safe bone marrow transplant programme that
meets international standards for the cure of sickle cell disease and is accessible to
Nigerians at home.
Nigeria has the most significant burden of Sickle Cell Disease worldwide. Individuals
affected with the disease suffer life-threatening and excruciating complications from early
childhood, serious damage to their organs, and reduced life expectancy. The
establishment of comprehensive care programmes, including newborn screening,
penicillin prophylaxis, and Transcranial Doppler screening in children to identify those at
risk of stroke, followed by using chronic blood transfusion therapy and the increasing use
of hydroxyurea therapy, has improved the proportion of children surviving into adulthood
but has not improved the proportion of adults living to older age, especially for the most
severely affected. Bone marrow transplant using a donor from a family member is an
established cure for this disease, first used more than 30 years ago. Bone marrow
transplant is associated with known complications such as infection and graft-versus-host
disease (when donor cells can attack the patient), infertility, and even death. However,
this procedure has been much improved over the last 20 years to ensure good outcomes
and limit complications. Bone marrow transplant is now an approved therapy for children
and adults with severe sickle cell disease. Bone marrow transplant is a complex
procedure requiring a multidisciplinary team approach and involves treatment and close
follow-up for approximately 12 months. The complexity and costs have severely limited
those who can obtain this treatment, and most have sought this treatment outside Nigeria,
which causes severe hardship for patients and families, only to come home with no local
expertise for follow-up.
Recognizing the gaps in care for individuals affected by the disease in Nigeria, the
leadership of the Sickle Cell Foundation Nigeria (SCFN) and Lagos University Teaching
Hospital (LUTH) established a bone marrow transplant programme at LUTH. In
preparation for a locally adapted and cost-effective bone marrow transplant programme
in Nigeria, a post-transplant clinic was initially established in 2019, a first in sub-Saharan
Africa, to provide post-transplant care to patients who had travelled to other countries for
bone marrow or stem cell transplants, thereby developing clinical expertise in posttransplant care. The programme also established a Stem Cell Processing Laboratory, the first in West Africa. This LUTH/SCFN bone marrow transplant programme consists of a
high-level multidisciplinary team that includes paediatric and adult haematologists,
including Dr. Seye Akinsete (Team lead) and Drs. Ugonna Fakile, Olufunto Kalejaiye,
Yusuf Adelabu, and Professor Edamisan Temiye (the Programme Manager), blood
transfusion and stem cell processing lab support (Professor Titi Adeyemo and Dr. Ann
Ogbenna), bone marrow-transplant nurses, dieticians, social workers, pharmacists,
psychiatrists, anaesthesiologists, nurses at the KidsOR (theatre) and other ancillary
2 personnel. The program has been guided by the scientific expertise and leadership of
Professor Adetola Kassim of Vanderbilt University Medical Center, who joined the
program in 2018. To further strengthen their expertise in the program, Prof Josu de la
Fuente from the Imperial College London Healthcare NHS Trust UK joined the team in
2022 as a resource person and assisted with the paediatric aspects of the programme.
Transplant Nursing has been supported by the Worldwide Network for Blood and Marrow
Transplantation (WBMT), which offers both in-person and virtual training at periodic
intervals.
Importantly, the role of Sickle Cell Foundation Nigeria (SCFN) in this Public Private
Partnership has been invaluable – providing administrative and project management
oversight under the leadership of the CEO, Dr. Annette Akinsete. The vision and
invaluable role of Prof. Olu Akinyanju, OON – Founder of SCFN is also well recognized.
The first set of patients are currently undergoing bone marrow transplants at Lagos
University Teaching Hospital and were admitted in the last week of August 2024. They
received a treatment regimen of exchange blood transfusions, chemotherapy and antiinfective prophylaxis to prepare them for the infusion of bone marrow stem cells that were
harvested from family donors, processed and given this week (17th and 19th September
2024). Both patients are currently undergoing immediate post-transplant care within the
transplant unit at Lagos University Teaching Hospital.
We want to express our appreciation to patients and families, the Management of the
Lagos University Teaching Hospital, especially the Chief Medical Director, Professor
Wasiu Lanre Adeyemo, and his predecessors (Prof. Chris Bode and Prof. Akin Osibogun),
the Sickle Cell Foundation Nigeria (The CEO, Dr. Annette Akinsete and board of directors
under the able leadership of its Chairman – Chief Tunde Afolabi, MFR), Lagos State
Government, Chevron/NNPCL, collaborative and technical partners, and other dedicated
staff who have been working around the clock to ensure the success of this programme.
Finally, we wish to express our profound gratitude to the Federal Ministry of Health &
Social Welfare (FMOH&SW) under the able leadership of the Coordinating Minister of
Health and Social Welfare (Prof. Muhammed Ali Pate), and the Honourable Minister of
State for Health (Dr Tunji Alausa) for their leadership, support and encouragement
throughout this long journey.
Prof. W. L. Adeyemo
Chief Medical Director, LUTH
FAS Dr. Annette Akinsete
National Director/ CEO, SCF
