Sickle cell disease (SCD) and thalassemia are lifelong genetic blood disorders that affect both children and adults. These conditions can cause chronic pain, anemia, fatigue, and increase the risk for infection and organ problems such as heart failure. In children, they may also slow growth and development.

SCD and thalassemia occur most often in people of African, Middle Eastern, or Southeast Asian descent. For a child to develop one of these conditions, both parents must usually pass on an abnormal gene.

• Sickle cell disease: Normally, red blood cells are round and flexible. With SCD, they become stiff and shaped like crescents or “sickles.” These cells can block blood flow, leading to pain episodes, fatigue, and long-term organ damage.
• Thalassemia: This condition reduces the body’s ability to make hemoglobin, the protein that carries oxygen in red blood cells. Low hemoglobin levels can cause anemia, bone changes, and an enlarged spleen.

Red blood cells carry oxygen using a protein called hemoglobin. Hemoglobin is made up of smaller building blocks called globin chains, which are produced by specific genes. When there's a change, or mutation, in one of these globin genes, the body may not make enough hemoglobin or may make hemoglobin that doesn’t work properly.

There are several types of SCD, including:

• HbSS or sickle cell anemia: Two sickle cell genes. It’s the most severe form of SCD.
• HbSC disease: One sickle cell gene and one other abnormal hemoglobin gene. It’s usually milder than HbSS.
• HbS beta thalassemia: One sickle cell gene and one beta-thalassemia gene. It can be mild or severe.
• HbSD, HbSE, and HbSO: A rare mix of a sickle cell gene and other genetic changes. Their severity varies.

There are 2 main types of thalassemia. They are:

• Alpha thalassemia: A gene related to the alpha globin protein is missing
• Beta thalassemia: A gene defect affects the production of the beta globin protein

At Carilion, we provide complete care for children with inherited blood diseases. We combine medical treatment with other forms of care to give children the best life possible.​

Medical treatments

We offer a range of medical treatments to help manage inherited blood diseases.

• Hydroxyurea therapy: For children with HbSS (sickle cell anemia) or HbS beta thalassemia, hydroxyurea can reduce pain episodes, hospitalizations, stroke risk, and other complications.
• Blood transfusions: Blood transfusions can help lower stroke risk in children with SCD, treat severe anemia, and improve oxygen delivery in certain situations, such as acute chest syndrome.
• Pain management: We use a combination of medication and nonmedication approaches to manage acute and chronic pain associated with SCD.
• Preventive care: To prevent infections and other complications, we make sure your child’s vaccines are up to date. If needed, they may get antibiotics to ward off infections.
• Monitoring of complications: We screen for pulmonary hypertension, kidney disease, retinopathy, stroke, and iron overload.

Supportive services

Having a lifelong blood disease affects children’s emotional and mental health. We offer the following services:​

• Educational resources: Programs to educate families about disease management and healthy lifestyle choices
• Care coordination: Social workers and other care team members help families navigate healthcare, insurance, and community resources, address challenges, and support continuity of care

Community support

The Sickle Cell Warriors support group provides people living with SCD and their caregivers an opportunity to connect, share experiences, and find support.