Hydroxyurea and fetal hemoglobin effect on leg ulcers in patients with sickle cell disease
© 2022. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply..
The presence of leg ulcers in individuals with sickle cell disease often represents an early sign of vasculopathy and future end organ damage. Pathophysiological mechanisms of formation and evolution of leg ulcers are poorly understood; nevertheless, HbF has been associated with lower incidence of leg ulcers, while hydroxyurea has been correlated with high risk of leg ulcers. As a result, there is hesitation regarding hydroxyurea use in patients with SCD and leg ulcers. In this study, we aim to define (1) a target of HbF that offers protection against leg ulcer development and (2) the impact of hydroxyurea therapy on leg ulcer prevalence. Our study demonstrated that in order to reduce leg ulcer incidence by one-third, a HbF > 25% is needed, a threshold not commonly reached and maintained in the adult SCD population. Importantly, leg ulcer incidence appears to be independent of HU use (p = 0.50). Our interpretation of this data is that the use of HU in a patient with SCD and leg ulcers should be guided by a careful assessment of risks and benefits of this therapeutic modality.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:101 |
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| Enthalten in: |
Annals of hematology - 101(2022), 3 vom: 01. März, Seite 541-548 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Tolu, Seda S [VerfasserIn] |
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| Links: |
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| Themen: |
9034-63-3 |
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| Anmerkungen: |
Date Completed 10.02.2022 Date Revised 10.02.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00277-021-04635-4 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a The presence of leg ulcers in individuals with sickle cell disease often represents an early sign of vasculopathy and future end organ damage. Pathophysiological mechanisms of formation and evolution of leg ulcers are poorly understood; nevertheless, HbF has been associated with lower incidence of leg ulcers, while hydroxyurea has been correlated with high risk of leg ulcers. As a result, there is hesitation regarding hydroxyurea use in patients with SCD and leg ulcers. In this study, we aim to define (1) a target of HbF that offers protection against leg ulcer development and (2) the impact of hydroxyurea therapy on leg ulcer prevalence. Our study demonstrated that in order to reduce leg ulcer incidence by one-third, a HbF > 25% is needed, a threshold not commonly reached and maintained in the adult SCD population. Importantly, leg ulcer incidence appears to be independent of HU use (p = 0.50). Our interpretation of this data is that the use of HU in a patient with SCD and leg ulcers should be guided by a careful assessment of risks and benefits of this therapeutic modality | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Hemoglobin F | |
| 650 | 4 | |a Hemoglobinopathy | |
| 650 | 4 | |a Hydroxyurea | |
| 650 | 4 | |a Leg ulcers | |
| 650 | 4 | |a Sickle cell Anemia | |
| 650 | 4 | |a Sickle cell disease | |
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