Hydroxyurea Treatment For Children With Sickle Cell Disease

Sickle cell anemia is a genetic disorder characterized by distorted, sickle shaped red blood cells. The disease is associated with severe pain, fatigue, and organ damage to the kidneys, spleen, and liver. The sickle cell disease is prevalent in African populations where the incidence is about 1 in 500.

Despite much clinical work, there is no good basic treatment for the disease. Pain can be relieved, and the frequency and duration of the crises can be lessened by rest, transfusions and antibiotics. It reduces quality of life, reproductive ability and life span.

A drug used for the treatment of sickle cell anemia in adults has now been shown to cause significant improvements in very young children with the disorder. The finding is an important one as these young patients are especially vulnerable to serious organ failure and even death at an early age.

In the new study, 21 children from two to four years old who had sickle cell anemia were given the drug hydroxyurea orally as a flavored liquid formula. A majority of the children took the drug for at least four years and more than half of the participants completed all six years of the study.

The treatment was well-tolerated in the patients, with only one child's dosage permanently reduced during the study due to adverse effects. Increasing and sustaining fetal hemoglobin production was accomplished by the drug in all study participants.

Patients treated with hydroxyurea also weighed more and were taller than untreated children with the disorder – their growth rates were even comparable to those of normal children. Another measure of success of the therapy was that the study patients had improved spleen function, an important finding as many children with sickle cell anemia lose spleen function by two years of age.

Participants also experienced significantly fewer incidents of acute chest syndrome, a potentially life-threatening disorder associated with sickle cell disease.

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"This study demonstrates that hydroxyurea is an efficient and safe treatment option for young children with sickle cell anemia," said Jane Hankins, lead study author. "As sickle cell anemia is a chronic disorder, having a drug that can be started early and continued long-term with few adverse effects is of significant importance to the way we treat this debilitating disease.”