Document Detail


Influence of severity of anemia on clinical findings in infants with sickle cell anemia: analyses from the BABY HUG study.
MedLine Citation:
PMID:  22190441     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Clinical complications of sickle cell anemia begin in infancy. BABY HUG (ClinicalTrials.gov, NCT00006400) was a NHLBI-NICHD supported randomized phase III placebo-controlled trial of hydroxyurea (HU) in infants (recruited at 9-18 months) unselected for clinical severity with sickle cell anemia. This secondary analysis of data from BABY HUG examines the influence of anemia on the incidence of sickle cell related complications, and the impact of hydroxyurea therapy in altering these events by comparing children with lower (<25th percentile) and higher (>75th percentile) hemoglobin concentrations at study entry.
PROCEDURE: Infants were categorized by: (1) age-adjusted hemoglobin quartiles as determined by higher (Hi) and lower (Lo) hemoglobin concentrations at study entry (9-12 months old: <8.0 and >10.0 gm/dL; 12-18 months old: <8.1 and >9.9 gm/dL) and (2) treatment arm (hydroxyurea or placebo). Four subgroups were created: placebo (PL) LoHb (n = 25), PL HiHb (n = 27), hydroxyurea (HU) LoHb (n = 21), and HU HiHb (n = 18). The primary and secondary endpoints of BABY HUG were analyzed by subgroup.
RESULTS: Infants with lower hemoglobin at baseline were more likely to have a higher incidence of clinical events (acute chest syndrome, pain crisis, fever) as well as higher TCD velocities and lower neuropsychological scores at study exit. Hydroxyurea reduced the incidence of these findings.
CONCLUSION: Infants with more severe anemia are at risk for increased clinical events that may be prevented by early initiation of hydroxyurea.
Authors:
Jeffrey D Lebensburger; Scott T Miller; Thomas H Howard; James F Casella; R Clark Brown; Ming Lu; Rathi V Iyer; Sharada Sarnaik; Zora R Rogers; Winfred C Wang;
Publication Detail:
Type:  Clinical Trial, Phase III; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-12-20
Journal Detail:
Title:  Pediatric blood & cancer     Volume:  59     ISSN:  1545-5017     ISO Abbreviation:  Pediatr Blood Cancer     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-08-13     Completed Date:  2012-10-15     Revised Date:  2013-04-16    
Medline Journal Info:
Nlm Unique ID:  101186624     Medline TA:  Pediatr Blood Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  675-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Wiley Periodicals, Inc.
Affiliation:
University of Alabama at Birmingham, Birmingham, Alabama, USA. jlebensburger@peds.uab.edu
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Anemia, Sickle Cell / blood,  complications*,  drug therapy,  physiopathology
Antisickling Agents / therapeutic use
Double-Blind Method
Fever / etiology
Hemoglobins / analysis
Humans
Hydroxyurea / therapeutic use
Infant
Kidney / physiopathology
Pain / etiology
Spleen / physiopathology
Thoracic Diseases / etiology
Grant Support
ID/Acronym/Agency:
N01-HB-07150/HB/NHLBI NIH HHS; N01-HB-07151/HB/NHLBI NIH HHS; N01-HB-07152/HB/NHLBI NIH HHS; N01-HB-07153/HB/NHLBI NIH HHS; N01-HB-07154/HB/NHLBI NIH HHS; N01-HB-07155/HB/NHLBI NIH HHS; N01-HB-07156/HB/NHLBI NIH HHS; N01-HB-07157/HB/NHLBI NIH HHS; N01-HB-07158/HB/NHLBI NIH HHS; N01-HB-07159/HB/NHLBI NIH HHS; N01-HB-07160/HB/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Antisickling Agents; 0/Hemoglobins; 127-07-1/Hydroxyurea

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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