Authors

M. H. Steinberg, Boston University
W. F. McCarthy, Maryland Medical Research Institute
O. Castro, Howard University
S. K. Ballas, Thomas Jefferson UniversityFollow
F. D. Armstrong, University of Miami
W. Smith, Virginia Commonwealth University
K. Ataga, University of North Carolina
P. Swerdlow, Wayne State University
A. Kutlar, Medical College of Georgia
L. DeCastro, Duke University
M. A. Waclawiw, National Heart Lung and Blood Institute
E. Orringer, Univerity of North Carolina
S. Jones, Univerity of North Carolina
D. Strayhorn, Univerity of North Carolina
W. Rosse, Duke University
G. Phillips, Duke University
D. Pearce, Duke University
A. Johnson-Telfair, Duke University
L. Daitch, Medical College of Georgia
P. Milner, Medical College of Georgia
A. Tracy, Medical College of Georgia
S. Valdez, Thomas Jefferson University
G. E. Allen, Thomas Jefferson University
J. Moshang, Thomas Jefferson University
B. Scott, Thomas Jefferson University
C. Bigelow, University of Mississippi
A. Anderson, University of Mississippi
V. Sabahi, University of Mississippi
T. Harrington, University of Miami School of Law
W. Labrousse, University of Miami
C. Pegelow, University of Miami
D. Temple, University of Miami
E. Case, University of Miami
R. Harrell, University of Miami
S. Childerie, University of Miami
S. Embury, San Francisco General Hospital
B. Schmidt, San Francisco General Hospital
D. Davies, San Francisco General Hospital
Y. Saunthararajah, University of Illinois
M. Koshy, University of Illinois
N. Talischy-Zahed, University of Illinois
L. Dorn, University of Illinois
G. Pendarvis, University of Illinois
M. McGee, University of Illinois
M. Telfer, Michael Reese Hospital
A. Davis, Michael Reese Hospital
O. C. Onyekwere, Howard University
C. Nwokolo, Howard University
H. Finke, Howard University
E. Perlin, Howard University
J. Siteman, Howard University
M. Bryan, University of Medicine and Dentistry of New Jersey
T. Saunders, University of Medicine and Dentistry of New Jersey
Y. Barber, University of Medicine and Dentistry of New Jersey
P. Gascon, University of Medicine and Dentistry of New Jersey
P. Di Paolo, University of Medicine and Dentistry of New Jersey
S. Gargiulo, University of Medicine and Dentistry of New Jersey
J. Eckman, Emory University
E. Carter-Randall, Emory University
J. H. Bailey, Emory University
A. Platt, Emory University
L. Waller, Emory University
G. Ramirez, St. Luke's-Roosevelt Medical Center
V. Knors, St. Luke's-Roosevelt Medical Center
S. Hernandez, St. Luke's-Roosevelt Medical Center
E. M. Rodriguez, St. Luke's-Roosevelt Medical Center
E. Wilkes, St. Luke's-Roosevelt Medical Center
E. Vichinsky, Children's Hospital of Oakland
W. Hagar, Children's Hospital of Oakland
C. Hoehner, Children's Hospital of Oakland
E. Hackney-Stevens, Children's Hospital of Oakland
S. Claster, Children's Hospital of Oakland
A. Earles, Children's Hospital of Oakland
K. Kleman, Children's Hospital of Oakland
K. McLaughlin, Children's Hospital of Oakland
L. White, Medical College of Virginia
B. Maddox, Medical College of Virginia
L. Usry, Medical College of Virginia
A. Brenner, Medical College of Virginia
K. Williams, Medical College of Virginia
R. O'Brien, Medical College of Virginia
K. Genther, Medical College of Virginia
S. Shurin, Case Western Reserve University
B. Berman, Case Western Reserve University
K. Chiarucci, Case Western Reserve University
L. Keverline, Case Western Reserve University
N. Olivieri, Hospital for Sick Children (Toronto General Hospital)
J. Chow, Hospital for Sick Children (Toronto General Hospital)
M. Hui, Hospital for Sick Children (Toronto General Hospital)
D. Shaw, Hospital for Sick Children (Toronto General Hospital)
N. Lewis, Hospital for Sick Children (Toronto General Hospital)
M. Okam, Brigham and Women's Hospital (Boston)
E. Mandell, Brigham and Women's Hospital (Boston)
A. Palmer, Brigham and Women's Hospital (Boston)
K. Bridges, Brigham and Women's Hospital (Boston)
B. Tynan, Brigham and Women's Hospital (Boston)
C. Winograd, Brigham and Women's Hospital (Boston)
R. Bellevue, Interfaith Medical Center (New York Methodist Hospital)
H. Dosik, Interfaith Medical Center (New York Methodist Hospital)
M. Sheikhai, Interfaith Medical Center (New York Methodist Hospital)
P. Ryans, Interfaith Medical Center (New York Methodist Hospital)
H. Souffrant, Interfaith Medical Center (New York Methodist Hospital)
B. Adler, University of Alabama
A. Johnson-Telfair, University of Alabama
L. Eskridge, University of Alabama
J. Prchal, University of Alabama
J. Braddock, University of Alabama
T. McArdle, University of Alabama
T. Carlos, University of Pittsburgh
A. Roundtree-Schmotzer, University of Pittsburgh
D. Gardner, University of Pittsburgh

Document Type

Article

Publication Date

6-1-2010

Comments

This article has been peer reviewed. It is the authors' final version prior to publication in American Journal of Hematology Volume 85, Issue 6, June 2010, Pages 403-408. The published version is available at DOI: 10.1002/ajh.21699. Copyright © Wiley InterScience

Abstract

A randomized, controlled clinical trial established the efficacy and safety of short-term use of hydroxyurea in adult sickle cell anemia. To examine the risks and benefits of long-term hydroxyurea usage, patients in this trial were followed for 17.5 years during which they could start or stop hydroxyurea. The purpose of this follow-up was to search for adverse outcomes and estimate mortality. For each outcome and for mortality, exact 95% confidence intervals were calculated, or tests were conducted at alpha = 0.05 level (P-value <0.05 for statistical significance). Although the death rate in the overall study cohort was high (43.1%; 4.4 per 100 person-years), mortality was reduced in individuals with long-term exposure to hydroxyurea. Survival curves demonstrated a significant reduction in deaths with long-term exposure. Twenty-four percent of deaths were due to pulmonary complications; 87.1% occurred in patients who never took hydroxyurea or took it for <5 years. Stroke, organ dysfunction, infection, and malignancy were similar in all groups. Our results, while no longer the product of a randomized study because of the ethical concerns of withholding an efficacious treatment, suggest that long-term use of hydroxyurea is safe and might decrease mortality.

HU pap Figure_1.doc (61 kB)
Figure 1.

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