Sickle cell disease, a genetically inherited blood disorder is a major cause of mortality and morbidity in Nigeria. This condition has significant pathological consequences that result in hemolytic events, induction of inflammatory process, vaso-occlusive episodes, and the stress response that leads to the induction of heat shock protein (HSP) 70. Therefore, this study aimed at correlating the level of serum heat shock protein 70 to haematological parameters in sickle cell subjects. A total of eighty-eight (88) consented participants were recruited for this study, which included apparently healthy persons with homozygous hemoglobin (HbAA 20), heterozygous hemoglobin (HbAS 30), homozygous hemoglobin (HbSS 30), and homozygous hemoglobin (HbSC 08). Subjects are in crisis and steady state. Venous blood samples (5 mls) were collected from subjects in ethylene diamine tetra acetic acid (EDTA) container and analyzed hemoglobin variants using hemoglobin electrophoresis, HSP 70 by Elisa method, and full blood count using standard methods. We demonstrated a significant increase (P<005) in HSP 70 levels of sickle cell disease HbSS and HbSC in steady state and crises when compared to the controls HbAA and HbAS. A significant (p<0.0001) increase noticed in the crisis state is higher than in the steady state. While the mean value of mean corpuscular hemoglobin concentration (MCHC) (35.1±43.4), pack cell volume (PCV) (22.4±2.7), hemoglobin (Hb) (8.8±0.9), absolute neutrophil count (386.4±31) and Absolute neutrophil count (7.0±2.1) in steady state subjects was significantly higher (p<0.01), as compared to crisis state (29.5±2.5, 21.8±3.4, 7.3±1.8, 269.5±42 and 6.5±2.5) for the respective parameters, whereas, mean corpuscular volume (30.5±3.1), white blood cell (16.8±3.4), absolute lymphocyte count (5.0±1.3) in sickle cell disease subject in crisis state are significantly higher (p<0.01) than in steady state (29.3±2.2, 11.3±2.8, 4.3±1.1) respectively. The mean value of mean corpuscular volume (87.3±8.2) in the crisis state was higher when compared to the steady state (83.5±7.2) and the mean value of red bloood cell (2.7±0.4) in the steady state was higher when compared to the crisis state (2.3±0.7). The differences were not significant (p<0.01). These findings suggest that an association exists between Hsp 70 and haematological parameters in sickle cell subjects. This implies that Hsp 70 might be a marker in oxidative stress, hypoxia, vaso-occlusion crisis, and increased serum Hsp 70 levels seem to reflect systemic inflammation. However, further studies are required to determine whether circulating Hsp 70 plays a causative role in the pathogenesis of sickle cell.

Sickle cell disorders (SCD) are a group of inherited disorders that results from both parent being carriers, haemoglobin AS resulting in haemoglobin (SS), causing anemia, infections, pain, stroke, priapism, sequenstration crisis, multiple organ dysfunctions etc. There are several ways of managing sickle cell disorder but the best way, which is considered a gold standard cure for the disease is a successful bone marrow transplant of haematopoietic stem cells (HSCT). Bone marrow (BM), Peripheral blood (PBSC) and Umbilical cord blood (UCB) are rich in stem cells. In order to have a good bone marrow transplant, without graft rejection, the laboratory plays a vital role especially in compatibility testing of donor and recipients at the various stages of the transplant, which includes initial stage, during the transplant and follow up testing to ensure tolerance to the new graft and testing for chimerism. There are various types of transplant which include Autologous, Allogeneic (Sibling/ Unrelated Donor), Parent or relative, etc. The various pre transplant tests includes: Sickling test, High Performance Liquid Chromatograph (HPLC), Genetic studies, RBC Indices Hb – 6-9 gm/dL, Peripheral Smear, Retic count Reticulocytosis, ESR, Bone marrow analysis. Post-transplant test Includes Engraftment Analysis, Complete Blood counts, kidney function, liver function, Cholesterol, HIV, Hepatitis B, Hepatitis C, additional infectious studies (Endemic testing), Urinalysis etc. Haemopoietic transplantation challenges in a resource limited settings like Nigeria are enormous and they includes: Danger of serious illness associated with donor-to-patient stem cell transplant, lack of appropriate donors, Graft-versus-host disease (GVHD), Inadequate Human resource, Inadequate equipped facility, cost of the service, Corruption, Lack of political will, Leadership incompétence, Lack of strategic planing, Policy inconsistency, Lack of qualified personnel, Poor healthcare administration, Conflict of interest among health workers. The cost of Bone Marrow Transplantation is highly exorbitant to Nigerians and government need to play vital role towards funding part of the cost and alleviating the pain of sickle cell. Effective implementation of National Health Insurance Scheme and address corruption are the most efficient ways the cost would be subsidized. Appropriate information campaigns largely championed by maternal and child health-care professionals would significantly contribute to raising the level of awareness and acceptance of Cord Blood donation. Training and re training of medical personnel cannot be over emphasized.