Hydroxyurea is associated with later onset of acute splenic sequestration crisis in sickle cell disease: Lessons from the European Sickle Cell Disease Cohort-Hydroxyurea (ESCORT-HU) study.


Journal

American journal of hematology
ISSN: 1096-8652
Titre abrégé: Am J Hematol
Pays: United States
ID NLM: 7610369

Informations de publication

Date de publication:
Apr 2024
Historique:
revised: 22 12 2023
received: 05 11 2023
accepted: 01 01 2024
pubmed: 22 1 2024
medline: 22 1 2024
entrez: 22 1 2024
Statut: ppublish

Résumé

Acute splenic sequestration crisis (ASSC) is a potentially life-threatening complication of sickle cell disease (SCD), typically occurring in young patients under 5 years of age, with a median age at first episode of less than 2 years. Because a beneficial effect of hydroxyurea (HU) on spleen perfusion and splenic function has been suspected, we hypothesized that HU treatment might be associated with later onset of ASSC in patients with SCD. To investigate this hypothesis, we analyzed data from the ESCORT-HU study on a large cohort of patients with SCD receiving HU, enrolled between January 2009 and June 2017 with a follow-up of 7309 patient-years of observation. The median age at ASSC of the 14 patients who experienced a first episode of ASSC during the study period was 8.0 [IQR: 5.0-24.1] years. The median age at HU initiation was significantly lower in these 14 patients (4.8 [IQR: 3.3-18.7] years) compared to the 1664 patients without ASSC (19.9 [8.8-33.4] years, p = .0008). These findings suggest that ASSC may occur at an unusually late age in patients receiving HU, possibly reflecting longer preservation of spleen perfusion and function secondary to early initiation of HU. Further studies are needed to better characterize the effects of HU on spleen perfusion/function and on the occurrence of ASSC in patients with SCD (ClinicalTrials.gov identifier: NCT02516579; European registry ENCEPP/SDPP/10565).

Identifiants

pubmed: 38247384
doi: 10.1002/ajh.27214
doi:

Banques de données

ClinicalTrials.gov
['NCT02516579']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

555-561

Subventions

Organisme : Addmedica

Informations de copyright

© 2024 Wiley Periodicals LLC.

Références

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Auteurs

Slimane Allali (S)

Department of General Pediatrics and Pediatric Infectious Diseases, Reference Center for Sickle Cell Disease, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Cité, Paris, France.

Frédéric Galactéros (F)

Department of Internal Medicine, Sickle Cell Referral Center, Henri-Mondor University Hospital-UPEC, AP-HP, Créteil, France.

Lena Oevermann (L)

Department of Pediatric Oncology and Hematology, Charité University Medicine, Berlin and Berlin Institute of Health, Berlin, Germany.

Giovanna Cannas (G)

Hospices Civils de Lyon, Hôpital Edouard Herriot, Médecine Interne, Centre de Référence Constitutif: Syndromes Drépanocytaires Majeurs, Thalassémies et Autres Pathologies Rares du Globule Rouge et de l'Erythropoïèse, Lyon, France.

Laure Joseph (L)

Biotherapy Department, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Cité, Paris, France.

Gylna Loko (G)

Centre Hospitalier Universitaire de Martinique, Centre de Référence Constitutif: Syndromes Drépanocytaires Majeurs, Thalassémies et Autres Pathologies Rares du Globule Rouge et de l'Érythropoïèse des Antilles et de la Guyane, Le Lamentin, Martinique, France.

Narcisse Elenga (N)

Centre Hospitalier de Cayenne, Centre de Référence Constitutif: Syndromes Drépanocytaires Majeurs, Thalassémies et Autres Pathologies Rares du Globule Rouge et de l'Erythropoïèse, Cayenne, French Guiana.

Malika Benkerrou (M)

Centre de Référence MCGRE, Service d'Hématologie-Immunologie, AP-HP, Hôpital Robert Debré, Inserm, UMR-1123 ECEVE, Université Paris Cité, Paris, France.

Maryse Etienne-Julan (M)

Unité Transversale de la Drépanocytose, Centre de Référence Maladies Rares pour la Drépanocytose aux Antilles-Guyane, CHU de Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe, France.

Marie-Pierre Castex (MP)

Pediatric Oncology Immunology Hematology Unit, Children's University Hospital - Toulouse University Hospital, Toulouse, France.

Valentine Brousse (V)

Department of General Pediatrics and Pediatric Infectious Diseases, Reference Center for Sickle Cell Disease, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Cité, Paris, France.
Centre de Référence MCGRE, Service d'Hématologie-Immunologie, AP-HP, Hôpital Robert Debré, Inserm, UMR-1123 ECEVE, Université Paris Cité, Paris, France.

Mariane de Montalembert (M)

Department of General Pediatrics and Pediatric Infectious Diseases, Reference Center for Sickle Cell Disease, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Cité, Paris, France.

Classifications MeSH