A Fayetteville teenager has become the first patient in North Carolina to receive a groundbreaking gene therapy for sickle cell disease, marking a significant milestone in the treatment of this debilitating genetic blood disorder.
Aaron Scott, 17, who was diagnosed with sickle cell disease at birth, has experienced a complete transformation in his quality of life following the innovative therapy. "It reminded me of glass shattering in my body," Scott described the pain he endured before treatment. "I could tell when a pain crisis was coming because my elbows and my wrist would start hurting, or my kneecaps or ankles."
Life Before Gene Therapy: A Struggle with Chronic Pain
Sickle cell disease is a genetic blood disorder affecting the protein that determines the shape and function of red blood cells. The condition disproportionately impacts minorities, with approximately 90% of cases occurring in African Americans.
For Scott, the disease manifested in chronic pain episodes beginning at age 2, which progressively worsened as he grew older. His guardian, Stephanie Miller-Scott, recalled the severity of his condition: "He was just so sick. He was in pain all of the time. Even when he wasn't in the hospital, he was in bed, in pain and medicated because that's the only thing he could do."
The debilitating nature of the disease forced Scott to attend school virtually rather than in-person due to the risk of infections. Even mild illnesses that would be inconsequential for his peers could potentially be life-threatening for him. In the 18 months prior to his treatment, Scott was hospitalized 13 times.
Cold temperatures were particularly problematic, triggering painful crises. "He couldn't have ice in his drink, he couldn't have a cold drink, he couldn't have a popsicle, he couldn't have ice cream in his birthday cake," Miller-Scott explained. "Anything cold triggered a crisis."
Revolutionary Treatment Approach
Dr. Kris Mahadeo, a cellular therapy specialist at Duke Health who treated Scott at Duke Children's Hospital, explained that the teen was an ideal candidate for the new therapy because he lacked a suitable bone marrow donor match.
"When you're doing a bone marrow transplant, you're using cells from another donor," Dr. Mahadeo explained. "You run the risk of donor cells can fight with the patient's body, which is something called graft versus host disease, or GVHD."
The gene therapy approach eliminates this risk by using the patient's own cells. "In gene therapy, you're using the patient's cells. You're engineering those cells to recover from sickle cell disease and essentially fix the deficits that's there. That in and of itself takes away that risk," Dr. Mahadeo added.
The FDA recently approved this gene therapy for patients 12 and older. Duke Health was involved in the clinical trials prior to federal approval, contributing to the development of this innovative treatment.
Remarkable Outcomes and Future Prospects
The results of the therapy have been transformative for Scott, who reports being completely pain-free since receiving the treatment two months ago. According to Dr. Mahadeo, "We expect more than 90% of patients to have no pain crises after the therapy."
This outcome is particularly significant given the reduced life expectancy associated with sickle cell disease. "The life expectancy for somebody with sickle cell disease is 45. That's way much less than the average American," noted Dr. Mahadeo. "So, the idea, that we hope, for patients with sickle cell disease we can improve that gap and patients can live normal lives length-wise, but also achieve everything else they were going to be able to achieve."
A New Chapter Begins
Now pain-free, Scott is embracing experiences that were previously impossible. He recently celebrated helping his sister learn to ride a bike and is preparing to graduate high school with his peers in May—a remarkable achievement considering he completed much of his schoolwork virtually between hospital stays.
The teen is also channeling his experience into creative expression, working on a comic book inspired by his journey. "It's kind of based on my story. It's about a boy who got sick and went to the hospital and he ended up with powers so he could heal people," Scott explained.
His message to others facing similar challenges reflects his resilient spirit: "Whatever you're going through, don't give up. God's got you. Keep pushing and don't give up."
As the first patient in North Carolina to receive this revolutionary therapy, Scott's success story represents a beacon of hope for the approximately 100,000 Americans living with sickle cell disease and highlights the transformative potential of gene therapy in addressing previously intractable genetic conditions.
