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Implementation of near-universal hydroxyurea uptake among children with sickle cell anemia: A single-center

Kristine Karkoska1, Kevin Todd1, Omar Niss1,2

  • 1Division of Hematology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.

Pediatric Blood & Cancer
|March 20, 2021
PubMed

Insights

Early hydroxyurea (hydroxyurea) use in children with sickle cell anemia (SCA) significantly reduced hospitalizations. Implementing guidelines for hydroxyurea treatment in pediatric SCA patients is feasible and improves outcomes.

Area of Science:

  • Hematology
  • Pediatric Medicine
  • Pharmacology

Background:

  • Sickle cell anemia (SCA) complications begin in childhood without early disease-modifying therapy.
  • Hydroxyurea is a safe and effective treatment for SCA complications.
  • Current hydroxyurea (hydroxyurea) utilization in pediatric SCA patients remains below recommended levels.

Purpose of the Study:

  • To evaluate the impact of updated guidelines on hydroxyurea (hydroxyurea) prescribing practices in pediatric SCA patients.
  • To assess changes in clinical outcomes following increased hydroxyurea (hydroxyurea) utilization.

Main Methods:

  • Retrospective review of hydroxyurea (hydroxyurea) prescribing practices and clinical outcomes over a 10-year period.
  • Analysis of data before and after the 2014 NHLBI recommendations for hydroxyurea (hydroxyurea) use in SCA.

Main Results:

  • Hydroxyurea (hydroxyurea) use in pediatric SCA patients increased from 43% to 95% between 2010 and 2019.
  • The median age of hydroxyurea (hydroxyurea) initiation decreased significantly after 2014.
  • SCA-related hospital admissions decreased by 42% during the study period.

Conclusions:

  • Early and universal hydroxyurea (hydroxyurea) prescription for children with SCA is the standard of care.
  • Implementing guidelines for hydroxyurea (hydroxyurea) treatment is feasible and leads to improved clinical outcomes.
  • This approach can serve as a model for other institutions to increase hydroxyurea (hydroxyurea) use in pediatric SCA patients.
Abstract

Keywords:
hydroxyureapediatricsprescriptionssickle cell anemia

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