Answer:
Sam inherited both of his parents' recessive alleles leading to sickle-cell anemia.
Step-by-step explanation:
When looking at genes and their expression, there tend to be two main types; dominant, and recessive. Dominant genes/alleles will usually "take over" leading to a certain gene being expressed. Recessive alleles will normally "hide" if you will, and are often not expressed in favor of the dominant allele being expressed. However, there's an exception when two recessive alleles are present.
It results in the recessive allele being expressed. In this case, Sam's parents both carried a recessive allele for sickle-cell anemia, and they also both had a dominant allele that prevented sickle-cell anemia from being expressed (normal red-blood cells). When they had Sam, he inherited both of their recessive alleles, which led to him having sickle-cell anemia.