Hydroxyurea therapy lowers TCD velocities in children with sickle cell disease

Tonya Kratovil, Dorothy Bulas, M. Catherine Driscoll, Barbara Speller-Brown, Robert McCarter, Caterina P. Minniti

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Introduction. Hydroxyurea (HU) improves hematologic paracmeters and decreases adverse events in patients with sickle cell disease (SCD). HU has been proposed as an alternative to chronic transfusions for secondary stroke prevention. Transcranial doppler (TCD) is an accepted method of stroke risk stratification in patients with SCD. We sought to determine if HU affects TCD velocities in children with SCD. Methods. A cohort of 24 children with HbSS with a baseline TCDi prior to HU and a follow-up after at least 6 months of therapy was analyzed. Twenty-four age-matched children with HbSS formed the control group. Differences in hematologic parameters before and after HU therapy were evaluated. Results. TCDi velocities decreased in the HU-treated patients. The adjusted mean change in TCDi velocities was -13.0 cm/sec (95% Cl -20.19, -5.92) in the HU-treated group and +4.72 cm/sec (95% Cl -3.24, 12.69) in the controls. Changes in TCDi between the two groups were statistically significant (P< 0.001). Changes in hematologic parameters were not predictive of changes in TCDi velocities in the treated patients. Four out of five patients with TCDi velocities >170 cm/sec had normalization of TCDi velocities on HU. Mean change was -34.75 cm/sec in this subgroup. No patients experienced cerebrovascular accidents (CVA) while on HU. Conclusions. HU-treated patients experienced statistically significant decreases in TCDi velocities compared to age-matched controls. Changes in hematologic parameters were not predictive of changes in TCDi velocities in the treated group. The decrease in TCDi velocities is not a consequence of changes in hematologic values in patients treated with HU.

Original languageEnglish (US)
Pages (from-to)894-900
Number of pages7
JournalPediatric Blood and Cancer
Volume47
Issue number7
DOIs
StatePublished - Dec 2006
Externally publishedYes

Fingerprint

Hydroxyurea
Sickle Cell Anemia
Therapeutics
Stroke
Secondary Prevention

Keywords

  • Hydroxyurea
  • Sickle cell disease
  • Stroke
  • Transcranial doppler

ASJC Scopus subject areas

  • Cancer Research
  • Pediatrics, Perinatology, and Child Health
  • Hematology

Cite this

Hydroxyurea therapy lowers TCD velocities in children with sickle cell disease. / Kratovil, Tonya; Bulas, Dorothy; Driscoll, M. Catherine; Speller-Brown, Barbara; McCarter, Robert; Minniti, Caterina P.

In: Pediatric Blood and Cancer, Vol. 47, No. 7, 12.2006, p. 894-900.

Research output: Contribution to journalArticle

Kratovil, T, Bulas, D, Driscoll, MC, Speller-Brown, B, McCarter, R & Minniti, CP 2006, 'Hydroxyurea therapy lowers TCD velocities in children with sickle cell disease', Pediatric Blood and Cancer, vol. 47, no. 7, pp. 894-900. https://doi.org/10.1002/pbc.20819
Kratovil, Tonya ; Bulas, Dorothy ; Driscoll, M. Catherine ; Speller-Brown, Barbara ; McCarter, Robert ; Minniti, Caterina P. / Hydroxyurea therapy lowers TCD velocities in children with sickle cell disease. In: Pediatric Blood and Cancer. 2006 ; Vol. 47, No. 7. pp. 894-900.
@article{eaeab4dcf1894eea9f5c17b89ee9f4f4,
title = "Hydroxyurea therapy lowers TCD velocities in children with sickle cell disease",
abstract = "Introduction. Hydroxyurea (HU) improves hematologic paracmeters and decreases adverse events in patients with sickle cell disease (SCD). HU has been proposed as an alternative to chronic transfusions for secondary stroke prevention. Transcranial doppler (TCD) is an accepted method of stroke risk stratification in patients with SCD. We sought to determine if HU affects TCD velocities in children with SCD. Methods. A cohort of 24 children with HbSS with a baseline TCDi prior to HU and a follow-up after at least 6 months of therapy was analyzed. Twenty-four age-matched children with HbSS formed the control group. Differences in hematologic parameters before and after HU therapy were evaluated. Results. TCDi velocities decreased in the HU-treated patients. The adjusted mean change in TCDi velocities was -13.0 cm/sec (95{\%} Cl -20.19, -5.92) in the HU-treated group and +4.72 cm/sec (95{\%} Cl -3.24, 12.69) in the controls. Changes in TCDi between the two groups were statistically significant (P< 0.001). Changes in hematologic parameters were not predictive of changes in TCDi velocities in the treated patients. Four out of five patients with TCDi velocities >170 cm/sec had normalization of TCDi velocities on HU. Mean change was -34.75 cm/sec in this subgroup. No patients experienced cerebrovascular accidents (CVA) while on HU. Conclusions. HU-treated patients experienced statistically significant decreases in TCDi velocities compared to age-matched controls. Changes in hematologic parameters were not predictive of changes in TCDi velocities in the treated group. The decrease in TCDi velocities is not a consequence of changes in hematologic values in patients treated with HU.",
keywords = "Hydroxyurea, Sickle cell disease, Stroke, Transcranial doppler",
author = "Tonya Kratovil and Dorothy Bulas and Driscoll, {M. Catherine} and Barbara Speller-Brown and Robert McCarter and Minniti, {Caterina P.}",
year = "2006",
month = "12",
doi = "10.1002/pbc.20819",
language = "English (US)",
volume = "47",
pages = "894--900",
journal = "Pediatric Blood and Cancer",
issn = "1545-5009",
publisher = "Wiley-Liss Inc.",
number = "7",

}

TY - JOUR

T1 - Hydroxyurea therapy lowers TCD velocities in children with sickle cell disease

AU - Kratovil, Tonya

AU - Bulas, Dorothy

AU - Driscoll, M. Catherine

AU - Speller-Brown, Barbara

AU - McCarter, Robert

AU - Minniti, Caterina P.

PY - 2006/12

Y1 - 2006/12

N2 - Introduction. Hydroxyurea (HU) improves hematologic paracmeters and decreases adverse events in patients with sickle cell disease (SCD). HU has been proposed as an alternative to chronic transfusions for secondary stroke prevention. Transcranial doppler (TCD) is an accepted method of stroke risk stratification in patients with SCD. We sought to determine if HU affects TCD velocities in children with SCD. Methods. A cohort of 24 children with HbSS with a baseline TCDi prior to HU and a follow-up after at least 6 months of therapy was analyzed. Twenty-four age-matched children with HbSS formed the control group. Differences in hematologic parameters before and after HU therapy were evaluated. Results. TCDi velocities decreased in the HU-treated patients. The adjusted mean change in TCDi velocities was -13.0 cm/sec (95% Cl -20.19, -5.92) in the HU-treated group and +4.72 cm/sec (95% Cl -3.24, 12.69) in the controls. Changes in TCDi between the two groups were statistically significant (P< 0.001). Changes in hematologic parameters were not predictive of changes in TCDi velocities in the treated patients. Four out of five patients with TCDi velocities >170 cm/sec had normalization of TCDi velocities on HU. Mean change was -34.75 cm/sec in this subgroup. No patients experienced cerebrovascular accidents (CVA) while on HU. Conclusions. HU-treated patients experienced statistically significant decreases in TCDi velocities compared to age-matched controls. Changes in hematologic parameters were not predictive of changes in TCDi velocities in the treated group. The decrease in TCDi velocities is not a consequence of changes in hematologic values in patients treated with HU.

AB - Introduction. Hydroxyurea (HU) improves hematologic paracmeters and decreases adverse events in patients with sickle cell disease (SCD). HU has been proposed as an alternative to chronic transfusions for secondary stroke prevention. Transcranial doppler (TCD) is an accepted method of stroke risk stratification in patients with SCD. We sought to determine if HU affects TCD velocities in children with SCD. Methods. A cohort of 24 children with HbSS with a baseline TCDi prior to HU and a follow-up after at least 6 months of therapy was analyzed. Twenty-four age-matched children with HbSS formed the control group. Differences in hematologic parameters before and after HU therapy were evaluated. Results. TCDi velocities decreased in the HU-treated patients. The adjusted mean change in TCDi velocities was -13.0 cm/sec (95% Cl -20.19, -5.92) in the HU-treated group and +4.72 cm/sec (95% Cl -3.24, 12.69) in the controls. Changes in TCDi between the two groups were statistically significant (P< 0.001). Changes in hematologic parameters were not predictive of changes in TCDi velocities in the treated patients. Four out of five patients with TCDi velocities >170 cm/sec had normalization of TCDi velocities on HU. Mean change was -34.75 cm/sec in this subgroup. No patients experienced cerebrovascular accidents (CVA) while on HU. Conclusions. HU-treated patients experienced statistically significant decreases in TCDi velocities compared to age-matched controls. Changes in hematologic parameters were not predictive of changes in TCDi velocities in the treated group. The decrease in TCDi velocities is not a consequence of changes in hematologic values in patients treated with HU.

KW - Hydroxyurea

KW - Sickle cell disease

KW - Stroke

KW - Transcranial doppler

UR - http://www.scopus.com/inward/record.url?scp=33750032587&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33750032587&partnerID=8YFLogxK

U2 - 10.1002/pbc.20819

DO - 10.1002/pbc.20819

M3 - Article

C2 - 16526051

AN - SCOPUS:33750032587

VL - 47

SP - 894

EP - 900

JO - Pediatric Blood and Cancer

JF - Pediatric Blood and Cancer

SN - 1545-5009

IS - 7

ER -