<P> Bone marrow transplants have proven effective in children . Bone marrow transplants are the only known cure for SCD . However, bone marrow transplants are difficult to obtain because of the specific HLA typing necessary . Ideally, a close relative (allogeneic) would donate the bone marrow necessary for transplantation . </P> <P> When treating avascular necrosis of the bone in people with sickle cell disease, the aim of treatment is to reduce or stop the pain and maintain joint mobility . Current treatment options are to rest the joint, physical therapy, pain relief medicine, joint replacement surgery, or bone grafting . High quality randomized controlled trials are needed to assess the most effective treatment option and determine if a combination of physical therapy and surgery are more effective than physical therapy alone . </P> <P> Psychological therapies such as patient education, cognitive therapy, behavioural therapy and psychodynamic psychotherapy, that aim to complement current medical treatments, require further research to determine their effectiveness . </P> <P> About 90% of people survive to age 20, and close to 50% survive beyond age 50 . In 2001, according to one study performed in Jamaica, the estimated mean survival for people with sickle cell was 53 years old for men and 58 years old for women with homozygous SCD . The specific life expectancy in much of the developing world is unknown . </P>

What is the mutation of sickle cell anemia