Effect of hydroxyurea on clinical and laboratory parameters of sickle cell anaemia patients in North–West Nigeria

Background Patients with sickle cell anaemia (SCA) are routinely managed with folic acid and paludrine in Nigeria. However, since the licensing of hydroxyurea (HU) by Food and Drug Administration in the USA in 1998, there has been a gradual but cautious use of HU in Nigeria, especially for SCA patients with severe disease. Aim The aim of this study was to determine the effects of HU on the frequency of hospital admissions, blood transfusion and haematological parameters among SCA patients in Zaria, Nigeria. Materials and methods This was a retrospective analytic study of patients with SCA on HU therapy at the haematology clinic of a teaching hospital in North–West Nigeria. The frequency of hospital admissions, blood units transfused per annum, haematocrit level and white blood cell (WBC) and platelet counts before and 1 year after commencing HU treatment were compared using paired sample t-test. P value lower to 0.05 was considered significant. Results In total, 18 of 689 (2.6%) registered SCA patients were on HU, and the mean age of patients was 26.5 years. The median (interquartile range) pre-HU and post-HU frequency of hospital admissions and units of blood transfused yearly were 4.5 (6) versus 1 (6) (P=0.003) and 2.5 (1) versus 0 (2) (P=0.001), respectively. Pre-HU and post-HU mean±SD haemocrit (%), WBC (×10^9/l) and platelet (×10^9/l) counts were 22.6 versus 26.6% (P 0.001), 14.8 versus 9.8 (P=0.002) and 468.3 versus 360.2 (P=0.144), respectively. Conclusion HU significantly reduced the frequency of hospital admissions and units of blood transfused with increase in haematocrit and reduction in WBC and platelet counts in patients with SCA. HU should be encouraged in patients with severe disease.