Sickle cell disease is an autosomal recessive disorder characterized by the presence of
sickle hemoglobin that leads to chronic
hemolysis and vaso-occlusive crisis. After decades of limited
therapy options,
crizanlizumab is a humanized
monoclonal antibody approved by the Food and Drug Administration (FDA) in 2019 for sickle cell-related
pain crises for patients 16 years of age and above. Although rare, infusion-related reactions, including painful crises, occurred in 3% as per the package insert. However, the data on how to deal with such reactions and about further treatment outcomes are limited as most patients stopped
crizanlizumab after the reaction. Herein, we report the good outcome of 13 doses of
crizanlizumab in a 19-year-old female patient with
sickle cell disease on
hydroxyurea, despite experiencing a severe infusion-related painful crisis during the second infusion. Additional benefits of
crizanlizumab, in this case, were preventing new episodes of
acute chest syndrome, quitting chronic
narcotics use, and a remarkable improvement in quality of life and overall performance.