Oscillatory haematopoiesis in adults with sickle cell disease treated with hydroxycarbamide.
Hydroxycarbamide therapy has been associated with significant oscillations in peripheral blood counts from myeloid, lymphoid and erythroid lineages in patients with polycythaemia vera and chronic myeloid leukaemia. We retrospectively evaluated serial blood counts over an 8-year period from 44 adult patients with sickle cell disease receiving hydroxycarbamide. Platelet counts, leucocyte counts, haemoglobin values and reticulocyte counts, apportioned by hydroxycarbamide status, were analysed using a Lomb-Scargle periodogram algorithm. Significant periodicities were present in one or more counts in 38 patients receiving hydroxycarbamide for a mean duration of 4·81 years. Platelet and leucocyte counts oscillated in 56·8% and 52·3% of patients, respectively. These oscillations generally became detectable within days of initiating therapy. During hydroxycarbamide therapy, the predominant periods of oscillation were 27 ± 1 d for platelet counts and 15 ± 1 d for leucocyte counts. Despite an absolute decrease in leucocyte and platelet counts during hydroxycarbamide treatment, the amplitudes between nadirs and zeniths remained similar regardless of exposure. Our observations appear consistent with previously proposed models of cyclic haematopoiesis, and document that hydroxycarbamide-induced oscillations in blood counts are innocuous phenomena not limited to myeloproliferative disorders as described previously. We speculate the known cell cycle inhibitory properties of hydroxycarbamide may accentuate otherwise latent constitutive oscillatory haematopoiesis.
Hematology Branch, National Heart, Lung and Blood Institute, Bethesda, MD, USA.
John H
JH
Baird
Caterina P
CP
Minniti
Jung-Min
JM
Lee
Xin
X
Tian
Colin
C
Wu
Mary
M
Jackson
Shoaib
S
Alam
James G
JG
Taylor
Gregory J
GJ
Kato
D000328:Adult; D000368:Aged; D000755:Anemia, Sickle Cell / Q000097:blood / Q000188:drug therapy; D000986:Antisickling Agents / Q000008:administration & dosage*; D001683:Biological Clocks / Q000187:drug effects*; D001772:Blood Cell Count; D005260:Female; D006410:Hematopoiesis / Q000187:drug effects*; D006801:Humans; D006918:Hydroxyurea / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D013997:Time Factors
D000986:Antisickling Agents; D006918:Hydroxyurea
complete peripheral blood count; hydroxycarbamide; oscillatory haematopoiesis; periodicity; sickle cell disease