Kristina Harrell, MD, decided she wanted to be a doctor when she was just 10 years old — after losing her favorite aunt to breast cancer.
Through high school and college, she became fascinated with hematology and oncology, and started learning about sickle cell disease. This genetic condition happens when red blood cells are shaped like crescent moons instead of round disks. This makes it harder for blood cells to move through the body, which can cause pain, organ damage and other serious health problems.
The more Dr. Harrell learned about sickle cell, the more she wanted to help those who have it – especially children.
“I learned that many kids weren’t getting the care they needed, often because of healthcare disparities and socioeconomic barriers,” Dr. Harrell says. “Then as I finished my medical training, both of my nieces were born with sickle cell, which made it so much more personal. I’ve dedicated my career to improving care and making sure children with sickle cell always have someone in their corner.”
Now Dr. Harrell directs the sickle cell program at Levine Children’s, leading the way as we take on some of the disease’s biggest challenges. From improving access to sickle cell care to studying futuristic cures, here are three ways we’re working to help kids with the disease live happier, healthier lives.
Bringing Sickle Cell Care Beyond Charlotte
Many sickle cell patients face geographic and socioeconomic barriers to getting the care they need. For example, some of Dr. Harrell’s patients live in rural communities, hours away from Charlotte.
“When kids don’t get the routine care they need, it affects their long-term health and puts them at higher risk for more severe complications,” Dr. Harrell says. “But when taking kids to appointments requires parents to travel and miss work, it forces some families to choose between working the hours they need to pay rent or getting their child medical care.”
Our team recently earned a grant to work with pediatricians in the region to help them provide more specialized sickle cell care.
“We’re educating primary care offices about sickle cell disease and how to tackle situations that may arise,” Dr. Harrell says. “This will enable more kids to get the care they need, closer to home.”
Providing personalized care for mental and physical health
Sickle cell can cause a variety of symptoms and health problems, from intense pain to lung problems to sleep apnea. We use a team approach to manage all these problems and improve a child's overall health. We also know that their health extends beyond their physical health.
“The psychosocial impact of sickle cell can’t be underestimated,” Dr. Harrell says. “A lot of people see kids who look mostly fine and don’t understand how serious the disease can be. We call our patients ‘warriors,’ because they fight through pain and stress every day, just to have the same level of normalcy as other children.”
That’s why our team gives all of our patients personalized psychosocial care. Our team approach includes care from:
- Psychologists: Who monitor the mental health of kids with sickle cell and teach them how to cope with common challenges like stress and anxiety. This helps them stay mentally strong during childhood and gives them the tools they need to be resilient throughout their lives.
- School liaisons: Kids with sickle cell disease are at higher risk for conditions like ADHD, stroke, and other conditions that can impact their learning. Our school liaisons help make sure our patients get the support they need to succeed in school – from support to help them manage learning differences to help catching up from days of missed school.
- Social workers: Sickle cell care can be complicated, long-lasting and expensive. Our social workers connect families with critical resources like help paying bills, and even work with legislators to advocate for better resources for families with sickle cell.
“If we don't make sure the child is succeeding in school, that can affect the way they feel about themselves, which may cause additional stress, which, in turn, could lead to more pain,” Dr. Harrell says. “Being able to provide a higher level of support, especially in the psychosocial and mental health realm, helps them succeed overall and reach their goals as they grow up.”
Developing Next-Generation Sickle Cell Treatments
For decades, the only treatment for sickle cell disease was a drug called Hydroxyurea. Two additional medicines have recently come on the market to help kids manage the condition, but they have their limits.
“These therapies help decrease pain and manage symptoms, but many people still experience severe pain, organ damage and other challenges,” Dr. Harrell says.
That’s why our team is helping shape the next generation of therapies and potential cures. We’re one the only hospital in the region to offer bone marrow transplants (BMT) for sickle cell patients, which started becoming available in the early 2000s.
“BMTs can cure sickle cell disease, but they can be very hard on kids because they often include intense chemotherapy,” Dr. Harrell says. “We take extra steps to make them safer, decrease the risk of complications and support families through the process.”
We’re also pursuing a potential way to help people overcome sickle cell, without the struggles of a bone marrow transplant: gene therapy. In this approach, scientists can change a child’s DNA so it cures the disease or makes it less severe. Our team is part of a clinical trial looking at how to use this therapy in the safest, most effective way. Down the road, we hope gene therapy may be able to cure sickle cell, without high dose chemotherapy or its long-term effects.
“We’ve come a long way, but we still have children who get very sick and young adults who pass away from sickle cell complications,” Dr. Harrell says. “That’s why we’re always looking for new cures. Someday, I hope this makes my job obsolete — or makes it so I can just administer the cure and never have to see kids suffer.”
Learn more about our sickle cell program at Levine Children’s
