title: Biological parameters predictive of percent dense red blood cell decrease under hydroxyurea.
abstract: BACKGROUND
  Dense red blood cells (DRBCs) are associated with chronic clinical manifestations of sickle-cell-disease (SCD). Hydroxyurea (HU) decreases the percent (%) DRBCs, thereby improving its therapeutic benefits, especially the prevention of SCD clinical complications, but parameters influencing %DRBCs remain unknown. The purpose of this study was to determine predictive biological parameters of %DRBC decline under HU.
  
  
  METHODS
  Factors affecting the %DRBC decrease in SCD patients HU-treated for ≥6 months were analyzed. Biological parameters and the %DRBCs were determined before starting HU and after ≥6 months of HU intake. Bivariate analyses evaluated the impact of each biological parameter variation on %DRBC changes under treatment. Multivariate analyses assessed the correlations between the decreased %DRBCs and biological parameters.
  
  
  RESULTS
  The %DRBCs declined by 40.95% after ≥6 months on HU. That decrease was associated with less hemolysis, however in several analyses on this group of patients we did not find a statistically significant correlation between decrease in %DRBCs and increase in HbF. Initial %DRBC values were the most relevant parameter to predict %DRBC decline.
  
  
  CONCLUSIONS
  Our results strengthen the known HU efficacy in SCD management statistically independently of the classical HbF biological response. Decreasing %DRBCs is essential to limiting chronic SCD symptoms related to DRBCs and predictive factors might help prevent those manifestations. The results of this study provide new perspectives on indication for HU use, i.e., to prevent SCD-induced organ damage.
authors.affiliation: Institut Mondor de Recherche Biomédicale, Unité 955, Equipe 2: Transfusion et Maladies du Globule Rouge, Université Paris-Est Créteil, Créteil, France. rmariegeorgine@yahoo.com.
authors.forename: Marie Georgine
authors.initials: MG
authors.lastname: Rakotoson
authors.affiliation: Institut Mondor de Recherche Biomédicale, Unité 955, Equipe 2: Transfusion et Maladies du Globule Rouge, Université Paris-Est Créteil, Créteil, France. gaetanadiliberto@yahoo.fr.|Etablissement Français du Sang, Île-de-France Mondor, Créteil, France. gaetanadiliberto@yahoo.fr.
authors.forename: Gaetana
authors.initials: G
authors.lastname: Di Liberto
authors.affiliation: Service de Santé Publique, Hôpital Henri-Mondor, APHP, LIC EA4393, Université Paris-Est Créteil, Créteil, France. etienne.audureau@gmail.com.
authors.forename: Etienne
authors.initials: E
authors.lastname: Audureau
authors.affiliation: Centre de Référence des Syndromes Drépanocytaires Majeurs, Hôpital Henri-Mondor, APHP, Université Paris-Est Créteil, 51, avenue du Mal-de-Lattre-de-Tassigny, 94010, Créteil Cedex, France. anoosha.habibi@aphp.fr.
authors.forename: Anoosha
authors.initials: A
authors.lastname: Habibi
authors.affiliation: Centre de Référence des Syndromes Drépanocytaires Majeurs, Hôpital Henri-Mondor, APHP, Université Paris-Est Créteil, 51, avenue du Mal-de-Lattre-de-Tassigny, 94010, Créteil Cedex, France. christine.fauroux@aphp.fr.
authors.forename: Christine
authors.initials: C
authors.lastname: Fauroux
authors.affiliation: Institut Mondor de Recherche Biomédicale, Unité 955, Equipe 2: Transfusion et Maladies du Globule Rouge, Université Paris-Est Créteil, Créteil, France. sanam_khmi@yahoo.com.|Etablissement Français du Sang, Île-de-France Mondor, Créteil, France. sanam_khmi@yahoo.com.
authors.forename: Sanam
authors.initials: S
authors.lastname: Khorgami
authors.affiliation: Laboratoire de Pharmacologie, APHP, Hôpital Henri-Mondor, Université Paris Est-Créteil, Créteil, France. anne.hulin@aphp.fr.
authors.forename: Anne
authors.initials: A
authors.lastname: Hulin
authors.affiliation: Laboratoire de Biochimie et Génétique, Hôpital Henri-Mondor, Créteil, France. sylvain.loric@aphp.fr.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Loric
authors.affiliation: Institut Mondor de Recherche Biomédicale, Unité 955, Equipe 2: Transfusion et Maladies du Globule Rouge, Université Paris-Est Créteil, Créteil, France. france.noizat-pirenne@efs.sante.fr.|Etablissement Français du Sang, Île-de-France Mondor, Créteil, France. france.noizat-pirenne@efs.sante.fr.
authors.forename: France
authors.initials: F
authors.lastname: Noizat-Pirenne
authors.affiliation: Institut Mondor de Recherche Biomédicale, Unité 955, Equipe 2: Transfusion et Maladies du Globule Rouge, Université Paris-Est Créteil, Créteil, France. frederic.galacteros@aphp.fr.|Centre de Référence des Syndromes Drépanocytaires Majeurs, Hôpital Henri-Mondor, APHP, Université Paris-Est Créteil, 51, avenue du Mal-de-Lattre-de-Tassigny, 94010, Créteil Cedex, France. frederic.galacteros@aphp.fr.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Galacteros
authors.affiliation: Institut Mondor de Recherche Biomédicale, Unité 955, Equipe 2: Transfusion et Maladies du Globule Rouge, Université Paris-Est Créteil, Créteil, France. pablo.bartolucci@aphp.fr.|Centre de Référence des Syndromes Drépanocytaires Majeurs, Hôpital Henri-Mondor, APHP, Université Paris-Est Créteil, 51, avenue du Mal-de-Lattre-de-Tassigny, 94010, Créteil Cedex, France. pablo.bartolucci@aphp.fr.
authors.forename: Pablo
authors.initials: P
authors.lastname: Bartolucci
mesh_terms: D000328:Adult; D000755:Anemia, Sickle Cell / Q000188:drug therapy*; D004913:Erythrocytes, Abnormal / Q000187:drug effects*; D005260:Female; D005319:Fetal Hemoglobin; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use*; D008297:Male
chemical_list: D005319:Fetal Hemoglobin; D006918:Hydroxyurea