title: The effect of hydroxyurea on compound heterozygotes for sickle cell-hemoglobin D-Punjab--a single centre experience in eastern India.
abstract: BACKGROUND
  Although hydroxyurea is the only effective agent for the treatment of sickle cell disease, published experience with this drug is limited to treatment of homozygous sickle cell anemia and HbS/β thalassemia. The role of hydroxyurea in the treatment of patients with HbSD-Punjab, a rare hemoglobinopathy with phenotypic expression similar to that of sickle cell anemia is unknown.
  
  
  METHODS
  Over a period of 10 years, we followed 42 patients with HbSD-Punjab, of which 20 presented with severe clinical manifestations (≥3 episodes of VOC and/or ≥2 units of blood transfusion in the previous 12 months). These 20 patients were enrolled for treatment with hydroxyurea at a dose of 10 mg/kg/day and followed prospectively for a period of 24 months.
  
  
  RESULTS
  The frequency of VOC decreased significantly and none of them required blood transfusion while receiving hydroxyurea. The HbF, total hemoglobin, MCV, MCH, and MCHC levels increased significantly, whereas HbS, WBC, platelet count, total serum bilirubin, and LDH levels decreased significantly in all the patients. No short-term drug toxicity was observed.
  
  
  CONCLUSIONS
  This study describes the use of hydroxyurea therapy in patients with HbSD-Punjab. Low dose hydroxyurea (10 mg/kg/day) was found to be effective in reducing the clinical severity in patients with HbSD-Punjab without any short-term toxicity. In view of easy affordability amongst poor patients, widespread acceptability by patients and doctors, the need of infrequent monitoring and its potential effectiveness, low dose hydroxyurea is suitable for treatment of patients with HbSD-Punjab.
authors.affiliation: Department Medicine, Veer Surendra Sai Medical College, Burla, Sambalpur, Odisha, India.
authors.forename: Siris
authors.initials: S
authors.lastname: Patel
authors.forename: Prasanta
authors.initials: P
authors.lastname: Purohit
authors.forename: Ranjeet Singh
authors.initials: RS
authors.lastname: Mashon
authors.forename: Snehadhini
authors.initials: S
authors.lastname: Dehury
authors.forename: Satyabrata
authors.initials: S
authors.lastname: Meher
authors.forename: Sulia
authors.initials: S
authors.lastname: Sahoo
authors.forename: Subhransu Sekhar
authors.initials: SS
authors.lastname: Dash
authors.forename: Kishalaya
authors.initials: K
authors.lastname: Das
authors.forename: Padmalaya
authors.initials: P
authors.lastname: Das
authors.forename: Dilip Kumar
authors.initials: DK
authors.lastname: Patel
mesh_terms: D000328:Adult; D000986:Antisickling Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006455:Hemoglobins, Abnormal; D006579:Heterozygote; D006801:Humans; D006918:Hydroxyurea / Q000008:administration & dosage* / Q000009:adverse effects; D007194:India; D007223:Infant; D008297:Male
chemical_list: D000986:Antisickling Agents; D006455:Hemoglobins, Abnormal; C026237:hemoglobin D Punjab; D006918:Hydroxyurea
keywords: HbSD-Punjab; Hydroxyurea; Sickle Cell Anemia; VOC