The Importance of Palliative Care in Sickle Cell Disease

Although a number of transformative sickle cell disease (SCD) therapy products are currently available, such as Vertex Pharmaceuticals' and CRISPR Therapeutics’ gene editing therapy exagamglogene autotemcel (exa-cel; marketed as Casgevy) and bluebird bio’s gene addition therapy lovotibeglogene autotemcel (lovo-cel; marketed as Lyfgenia), palliative care may still remain an important part of SCD treatment. Indeed, a new study presented at the 67th American Society of Hematology (ASH) Annual Meeting and Exposition, held December 6 to 9, 2025, in Orlando, Florida, indicated that the introduction of palliative care was able to substantially reduce hospital stay times of hospitalized patients with SCD.

CGTLive® sat down on the conference floor with Crawford Strunk, MD, an associate staff member at the Cleveland Clinic and the codirector of the Sickle Cell Medical Neighborhood, who presented the study, to get his insight on the key findings and their implications. Strunk highlighted the approximately 65% reduction in hospital stay time reported in the study and discussed plans to evaluate whether this result will hold over longer periods of time than the study assessed.

CGTLive: Could you give a little bit of background context about your presentation?

Crawford Strunk, MD: As you know, SCD is a disease that affects about 100,000 people [in the United States]. Pain is the hallmark of the disease and, unfortunately, a lot of patients have significant issues with chronic pain. What we know is that in the US, it accounts for over $800,000,000 of cost to the healthcare system. Furthermore, even though there's a high disease burden and evidence of benefit, unfortunately palliative care is underutilized in hospital admissions and in general for SCD patients.

What were the key findings of your study?

What we did was integrate our palliative care team into our Sickle Cell Medical Neighborhood, and we did that in order to help provide both outpatient pain management and strategies to help manage that, as well as inpatient pain management. The way we did that was to create a palliative care and hematology consult trigger when SCD patients are admitted to the hospital. By doing that and working on individualized care plans, focusing on integrating our hospitalist teams and developing individual care plans for patients, both inside the hospital and inside the emergency department, what it did was reduce our length of stay by about 65%. We did that by providing care through not just our quaternary care hospitals, but also our community hospitals, and integrating the teams through multidisciplinary team meetings, as well as careful strategies in terms of opioid stewardship and careful guidance from both the hematologists and the palliative care teams... Even though the medical neighborhood is growing in terms of numbers of patients, we've been able to maintain that length of stay and actually decrease it over the course of a 1 year period.

How would you summarize the big picture takeaways from that?

The big picture for our results is that if you have access to palliative care, our study demonstrates that integrating them into your SCD comprehensive care model is integral to help reduce length of stay and to improve inpatient and outpatient pain management, improve opioid stewardship, and provide wraparound care for patients who suffer from chronic pain and acute on chronic pain.

Are there any unanswered questions with this research that you can discuss a bit?

One of the things that we're looking into right now is: Does this model hold for longer periods of time than just what we did study wise, and do we need to make any changes to it as we move forward? We just looked at our last 6 months of data and showed that we have been averaging about the same length of stay as we have previously, within that 3 and a half to 5 and a half day range, which demonstrates that the model that we have incorporated has been able to maintain the benefit that we saw over the first year's worth of the study.

What I would also recommend is if you have a palliative care available through either your cancer center or through an independent group, that integrating them can be significantly helpful. Not only would patients have better pain management strategies, but this could also be a cost reduction for the hospitals in terms of improved outpatient and inpatient services provided.

This transcript has been edited for clarity.