{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:04:14Z","timestamp":1789016654878,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T00:00:00Z","timestamp":1616112000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Without early initiation of disease\u2010modifying therapy, the acute and chronic complications of sickle cell anemia (SCA) begin early in childhood and progress throughout life. Hydroxyurea is a safe and effective medication that reduces or prevents most SCA\u2010related complications. Despite recommendations to prescribe hydroxyurea for all children with SCA as young as 9\u00a0months, utilization remains low.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>We completed a retrospective review of hydroxyurea\u2010prescribing practices and associated clinical outcomes at our institution over a 10\u2010year period before and after the 2014 National Heart, Lung, and Blood Institute (NHLBI) recommendations to use hydroxyurea for all children with SCA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Hydroxyurea use more than doubled within our pediatric SCA population from 43% in 2010 to 95% in 2019. The age of hydroxyurea initiation was significantly younger during 2014\u20132019 compared to 2010\u20132013 (median 2\u00a0years vs. 6\u00a0years, <jats:italic>p<\/jats:italic>\u00a0\u2264\u00a0.001). With this change in clinical practice, nearly all (69\/71\u00a0=\u00a097%) children born after 2013 received disease\u2010modifying therapy by the end of 2019, primarily hydroxyurea (93%). Concurrently, the number of SCA\u2010related admissions significantly decreased from 67\/100 patient\u2010years in 2010 to 39\/100 patient\u2010years in 2019 (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The early and universal prescription of hydroxyurea for children with SCA is the standard of care. Here, we demonstrate that a careful and deliberate commitment to follow this guideline in clinical practice is feasible and results in measurable improvements in clinical outcomes. Our approach and improved outcomes can serve as a model for other programs to expand their hydroxyurea use for more children with SCA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.29008","type":"journal-article","created":{"date-parts":[[2021,3,20]],"date-time":"2021-03-20T06:52:43Z","timestamp":1616223163000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Implementation of near\u2010universal hydroxyurea uptake among children with sickle cell anemia: A single\u2010center experience"],"prefix":"10.1002","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0990-399X","authenticated-orcid":false,"given":"Kristine","family":"Karkoska","sequence":"first","affiliation":[{"name":"Division of Hematology, Cancer and Blood Diseases Institute Cincinnati Children's Hospital Medical Center  Cincinnati Ohio 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Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2372-2175","authenticated-orcid":false,"given":"Charles T.","family":"Quinn","sequence":"additional","affiliation":[{"name":"Division of Hematology, Cancer and Blood Diseases Institute Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9582-0594","authenticated-orcid":false,"given":"Russell E.","family":"Ware","sequence":"additional","affiliation":[{"name":"Division of Hematology, Cancer and Blood Diseases Institute Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6198-4785","authenticated-orcid":false,"given":"Patrick T.","family":"McGann","sequence":"additional","affiliation":[{"name":"Division of Hematology, Cancer and Blood Diseases Institute Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine  Cincinnati Ohio 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