An evaluation of effect of hydroxyurea on frequency of blood transfusion, vaso-occlusive crisis and hospitalisation in children of sickle cell anemia
DOI:
https://doi.org/10.18203/2349-3291.ijcp20223416Keywords:
SCA, Hydroxyurea, VOC, Blood transfusion, HospitalisationAbstract
Background: Hydroxyurea therapy is a known effective and safe therapy for the treatment of sickle cell anemia (SCA). Although it is used worldwide in our Indian based setup, it is underutilized not only due to economic reasons but also due to unaware practitioners about its use.
Methods: An ambispective observational study was performed at our tertiary care center over a period of 1 year 8 months. One hundred and ninety patients were enrolled after taking a complete history, then started on Hydroxyurea and followed up every 2 months till 1 year. On follow-up, frequency of vaso-occlucive crisis, blood transfusion and hospitalization were noted along with routine investigations and for any side effects.
Results: Of 190 total recruited patients, 84 were studied at the end because of loss to follow-up due to various reasons. Significant decrease in the frequency of vaso-occlusive crisis (VOC), blood transfusion and hospitalisation were observed within 1 year of starting hydroxyurea (p<0.05).
Conclusions: The use of hydroxyurea in our native population at our setup can decrease the frequency of vasooccluisve crisis, blood transfusion and hospitalisation in sickle cell patients.
References
Bhatia HM and Rao VR. Genetic Atlas of the Indian Tribes. New Delhi: Institute of Immunohematology. Indian Council of Medical Res. 1986.
Colah RB, Mukherjee MB, Martin S and Ghosh K. Sickle cell disease in tribal populations in India. Indian J Med Res. 2015;141(5):509-15.
Negi RS. Sickle cell trait in India. A review of known distribution. Bull Anthropol Surv India. 1972;17:439-49.
Shrikhande AV, Dani AA, Tijare JR, Agrawal AK. Hematological profile of sickle cell disease in central India. Indian J Hematol Blood Transfus. 2007;23(3):92-8.
Maier-Redelsperger M, de Montalembert M, Flahault A, Neonato MG, Ducrocq R, Masson MP et al. Fetal hemoglobin and f-cell responses to long- term hydroxyurea treatment in young sickle cell patients. Blood. 1998;91(12):4472-9.
Ndefo UA, Maxwell AE, Nguyen H, Chiobi TL. Pharmacological management of sickle cell disease. PT. 2008;33(4):238-43.
Agrawal RK, Patel RK, Shah V, Nainiwal L, Trivedi B. Hydroxyurea in sickle cell disease: Drug review. Indian J Hematol Blood Transfus. 2014;30(2):91-6.
Brawley OW, Cornelius LJ, Edwards LR, Gamble VN, Green BL, Inturrisi C et al. National institutes of health consensus development conference statement: Hydroxyurea treatment for sickle cell disease. Ann Intern Med. 2008;148(12): 932-8.
Jain DL, Apte M, Colah R, Sarathi V, Desai S, Gokhale A, et al. efficacy of fixed low dose hydroxyurea in indian children with sickle cell anemia: A single centre experience. Indian Pediatr. 2013;50(10):929-33.
Pondugala SK, Varanasi PK, Rao KM and Vegesna S. To assess the efficacy of hydroxyurea, in children with homozygous sickle cell disease, in the age group of 1 year to 18 years, at tertiary care hospital. J NTR Univ Health Sci. 2012;1(4):227-32.
Silva-Pinto AC, Angulo IL, Brunetta DM, Neves FI, Bassi SC, Santis GC et al. Clinical and hematological effects of hydroxyurea therapy in sickle cell patients: A single-center experience in Brazil. Sao Paulo Med J. 2013;131(4):238-43.
Barbosa BL. Clinical and laboratory effects of hydroxyurea in children and adolescents with sickle cell anemia: a Portuguese hospital study. Hemoglobin. 2005;29(3):171-18.
Alima AY. Clinical and Biological Profile of Patients Treated with Hydroxyurea at the Mother and Child Center of Chantal Biya Foundation. Heal Sci Dis. 2020;21(4).
Jain DL, Apte M, Colah R. Efficacy of fixed low dose hydroxyurea in Indian children with sickle cell anemia: A single centre experience . Indian Pediatr. 2013;50:929-33.
Phan V, Park J, Dulman R. Ten-year Longitudinal Analysis of Hydroxyurea Implementation in a Pediatric Sickle Cell Program. Authorea. 2022;26.
Alina F. Hydroxyurea for treatment of severe sickle cell anemia: a pediatric clinical trial. Blood. 1996;88(6):1960-4.
