Kinder- und Jugendmedizin 2022; 22(01): 09-15
DOI: 10.1055/a-1675-6602
Schwerpunkt

Neugeborenenscreening auf Sichelzellkrankheit

Newborn screening for sickle cell disease
Stephan Lobitz
1   Gemeinschaftsklinikum Mittelrhein Koblenz, Klinik für Pädiatrische Hämatologie und Onkologie
› Author Affiliations

ZUSAMMENFASSUNG

Die Sichelzellkrankheit (SCD) ist eine schwere angeborene Bluterkrankung, die mit einer hohen Morbidität und Mortalität im Säuglings- und Kleinkindalter einhergeht, wenn sie noch nicht diagnostiziert worden ist. Kritisch sind insbesondere fulminante bakterielle Infektionen im Rahmen der krankheitstypischen Hyposplenie sowie akute Verschlechterungen der im Intervall stabilen Anämie. Mit sehr einfachen Maßnahmen (Schulung, Impfung und Penicillin-Prophylaxe) lässt sich ein Großteil der schweren Komplikationen vermeiden. Da die Erkrankung schon bei Geburt sehr einfach und sehr zuverlässig aus Trockenblut diagnostizierbar ist und zudem inzwischen ein gutes therapeutisches Konzept existiert, gibt es eine gute Rationale für ein Neugeborenenscreening (NBS). International werden Neugeborene teilweise schon seit den frühen 1970er-Jahren auf die SCD untersucht. Das flächendeckende NBS in Deutschland hat am 1. Oktober 2021 begonnen. Dieser Artikel gibt Ihnen einen Überblick über die neue Zielkrankheit.

ABSTRACT

Sickle cell disease (SCD) is a severe inherited blood disease and associated with significant morbidity and mortality in infancy and early childhood if still undiagnosed. Fulminant bacterial infections secondary to typical hyposplenia as well as acute worsening of anemia are most critical. Very easy measures (education, vaccination, and penicillin prophylaxis) are capable of virtually eliminating these severe complications. SCD can be diagnosed reliably at birth with very simple methods from dried blood spots. Since there is also a reasonable therapeutic strategy in place, there is a good rationale for newborn screening (NBS). Some countries have started to test newborns for SCD as early as the 1970 s. In Germany, NBS for SCD started on 1 October 2021. This article will give you an overview about the new target disease.



Publication History

Received: 02 July 2021

Accepted: 20 July 2021

Article published online:
25 February 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG,
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • Literatur

  • 1 Piel FB, Steinberg MH, Rees DC. Sickle Cell Disease. N Engl J Med 2017; 376: 1561-1573
  • 2 Ballas SK, Lieff S, Benjamin LJ. et al Definitions of the phenotypic manifestations of sickle cell disease. Am J Hematol 2010; 85: 6-13
  • 3 Ballas SK. Sickle cell disease: Classification of clinical complications and approaches to preventive and therapeutic management. Clin Hemorheol Microcirc 2018; 68: 105-128
  • 4 Piel FB, Patil AP, Howes RE. et al Global distribution of the sickle cell gene and geographical confirmation of the malaria hypothesis. Nat Commun 2010; 01: 104
  • 5 Piel FB, Hay SI, Gupta S. et al Global burden of sickle cell anaemia in children under five, 2010–2050 modelling based on demographics, excess mortality, and interventions. PLoS Med 2013; 10: e1001484
  • 6 Kunz JB, Lobitz S, Grosse R. et al Sickle cell disease in Germany: Results from a national registry. Pediatr Blood Cancer 2020; 67: e28130
  • 7 Kunz JB, Cario H, Grosse R. et al The epidemiology of sickle cell disease in Germany following recent large-scale immigration. Pediatr Blood Cancer 2017: 64
  • 8 Pattloch D. Sickle Cell Disease in Newborns in Germany: Analysis of the AOK Health Insurance Data. Gesundheitswesen 2019; 81: 986-992
  • 9 Hoppe C, Neumayr L. Sickle Cell Disease: Monitoring, Current Treatment, and Therapeutics Under Development. Hematol Oncol Clin North Am 2019; 33: 355-371
  • 10 Serjeant GR, Serjeant BE. Management of sickle cell disease; lessons from the Jamaican Cohort Study. Blood Rev 1993; 07: 137-145
  • 11 Voskaridou E, Christoulas D, Bilalis A. et al The effect of prolonged administration of hydroxyurea on morbidity and mortality in adult patients with sickle cell syndromes: results of a 17-year, single-center trial (LaSHS). Blood 2010; 115: 2354-2363
  • 12 Ataga KI, Kutlar A, Kanter J. et al Crizanlizumab for the Prevention of Pain Crises in Sickle Cell Disease. N Engl J Med 2017; 376: 429-439
  • 13 Niihara Y, Miller ST, Kanter J. et al A Phase 3 Trial of l-Glutamine in Sickle Cell Disease. N Engl J Med 2018; 379: 226-235
  • 14 Vichinsky E, Hoppe CC, Ataga KI. et al A Phase 3 Randomized Trial of Voxelotor in Sickle Cell Disease. N Engl J Med 2019; 381: 509-519
  • 15 de la Fuente J, Dhedin N, Koyama T. et al Haploidentical Bone Marrow Transplantation with Post-Transplantation Cyclophosphamide Plus Thiotepa Improves Donor Engraftment in Patients with Sickle Cell Anemia: Results of an International Learning Collaborative. Biol Blood Marrow Transplant 2019; 25: 1197-1209
  • 16 Tisdale J. Improvements in haploidentical transplantation for sickle cell disease and beta-thalassaemia. Lancet Haematol 2019; 06: e168-e169
  • 17 Gluckman E, Cappelli B, Bernaudin F. et al Sickle cell disease: an international survey of results of HLA-identical sibling hematopoietic stem cell transplantation. Blood 2017; 129: 1548-556
  • 18 Gluckman E, Fuente J, Cappelli B. et al The role of HLA matching in unrelated donor hematopoietic stem cell transplantation for sickle cell disease in Europe. Bone Marrow Transplant 2020; 55: 1946-1954
  • 19 Garg H, Tatiossian KJ, Peppel KB. et al Gene therapy as the new frontier for Sickle Cell Disease. Curr Med Chem. 2021 May 26
  • 20 Lobitz S, Frommel C, Brose A. et al Incidence of sickle cell disease in an unselected cohort of neonates born in Berlin, Germany. Eur J Hum Genet 2014; 22: 1051-1053
  • 21 Lobitz S, Klein J, Brose A. et al Newborn screening by tandem mass spectrometry confirms the high prevalence of sickle cell disease among German newborns. Ann Hematol 2019; 98: 47-53
  • 22 Kunz JB, Awad S, Happich M. et al Significant prevalence of sickle cell disease in Southwest Germany: results from a birth cohort study indicate the necessity for newborn screening. Ann Hematol 2016; 95: 397-402
  • 23 Grosse R, Lukacs Z, Cobos PN. et al The Prevalence of Sickle Cell Disease and Its Implication for Newborn Screening in Germany (Hamburg Metropolitan Area). Pediatr Blood Cancer 2016; 63: 168-170
  • 24 Lobitz S, Telfer P, Cela E. et al Newborn screening for sickle cell disease in Europe: recommendations from a Pan-European Consensus Conference. Br J Haematol 2018; 183: 648-660