title: Hydroxyurea and growth in young children with sickle cell disease.
abstract: BACKGROUND
  Growth impairment is a known complication of sickle cell disease. Effects of hydroxyurea (HU) on growth in very young children are not known.
  
  
  METHODS
  Height, weight, BMI, and head circumference (HC) were compared with World Health Organization (WHO) standards in BABY HUG, a multicenter, randomized, double-blinded, placebo-controlled 2-year clinical trial of HU in 193 children 9 to 18 months of age. Anthropometric data were closely monitored and converted to z scores by using WHO standardized algorithms for descriptive analyses. The treatment and placebo groups were compared longitudinally by using a mixed model analysis.
  
  
  RESULTS
  At entry, the z scores of BABY HUG children were higher than WHO norms. After 2 years of HU or placebo treatment, there were no significant differences between the groups, except for the mean HC z scores at study exit (HU: +0.8 versus placebo: +1.0, P = .05). Baseline z scores were the best predictors of z scores at study exit. The absolute neutrophil count, absolute reticulocyte count, and total white blood cell count had significant negative correlations with growth measures.
  
  
  CONCLUSIONS
  Both groups had normal or near normal anthropometric measures during the study. The HC z scores at study entry and exit were slightly greater than WHO norms. Higher baseline white blood cell count, absolute reticulocyte count, and absolute neutrophil count were associated with poorer growth. The significance of the slightly lower HC in the treatment group at study exit is not clear. Trends toward normalization of weight and height and effects on HC will be monitored in ongoing BABY HUG follow-up studies.
authors.affiliation: Department of Pediatrics and Child Health, Howard University, Washington, District of Columbia; srana@howard.edu.
authors.forename: Sohail
authors.initials: S
authors.lastname: Rana
authors.affiliation: Department of Pediatrics and Child Health, Howard University, Washington, District of Columbia;
authors.forename: Patricia E
authors.initials: PE
authors.lastname: Houston
authors.affiliation: St. Jude Children's Research Hospital, Memphis, Tennessee;
authors.forename: Winfred C
authors.initials: WC
authors.lastname: Wang
authors.affiliation: University of Mississippi Medical Center, Jackson, Mississippi;
authors.forename: Rathi V
authors.initials: RV
authors.lastname: Iyer
authors.affiliation: National Heart, Lung, and Blood Institute, Bethesda, Maryland;
authors.forename: Jonathan
authors.initials: J
authors.lastname: Goldsmith
authors.affiliation: Division of Hematology, Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland;
authors.forename: James F
authors.initials: JF
authors.lastname: Casella
authors.affiliation: Department of Pediatrics and Child Health, Howard University, Washington, District of Columbia;
authors.forename: Caroline K
authors.initials: CK
authors.lastname: Reed
authors.affiliation: UT Southwestern Medical Center, Dallas, Texas; and.
authors.forename: Zora R
authors.initials: ZR
authors.lastname: Rogers
authors.affiliation: National Heart, Lung, and Blood Institute, Bethesda, Maryland;
authors.forename: Myron A
authors.initials: MA
authors.lastname: Waclawiw
authors.affiliation: Clinical Trials & Surveys Corporation, Owings Mills, Maryland.
authors.forename: Bruce
authors.initials: B
authors.lastname: Thompson
mesh_terms: D000755:Anemia, Sickle Cell / Q000188:drug therapy*; D000986:Antisickling Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D049628:Body Size / Q000187:drug effects* / Q000502:physiology*; D001835:Body Weight / Q000187:drug effects / Q000502:physiology; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006918:Hydroxyurea / Q000494:pharmacology* / Q000627:therapeutic use*; D007223:Infant; D008137:Longitudinal Studies; D008297:Male
chemical_list: D000986:Antisickling Agents; D006918:Hydroxyurea
keywords: BMI; children; growth; head circumference; height; hydroxyurea; sickle cell disease; weight