{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:06:44Z","timestamp":1785769604073,"version":"3.56.0"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,4,20]],"date-time":"2013-04-20T00:00:00Z","timestamp":1366416000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2013,6]]},"abstract":"Abstract<\/jats:title>Background and Objectives<\/jats:title>Hydroxyurea (HU<\/jats:styled-content>) is the standard treatment for severely affected children with sickle cell disease (SCD<\/jats:styled-content>). Starting dose is 15\u201320\u00a0mg\/kg\/day that can be escalated up to 35\u00a0mg\/kg\/day. Ethnic neutropenia is common in this area of the world that requires judicious usage of myelosuppressive drugs. Aim was to assess the efficacy of a lower initial dose of HU<\/jats:styled-content> and cautious dose escalation regimen in patients with SCD<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>We assessed 161 patients with SCD<\/jats:styled-content> on HU<\/jats:styled-content>, at Sultan Qaboos University Hospital (SQUH<\/jats:styled-content>), Muscat, Oman, retrospectively from 1998 to 2008 and prospectively from 2009 to 2011. Starting dose of HU<\/jats:styled-content> was 10\u201312\u00a0mg\/kg\/day, adjusted based on response or side effects. Patients were divided into two groups according to the dose of HU<\/jats:styled-content> (10\u201315.9\u00a0mg\/kg\/day and 16\u201326\u00a0mg\/kg\/day).<\/jats:p><\/jats:sec>Results<\/jats:title>Nineteen patients were excluded for various reasons. Forty\u2010four children were in the low\u2010dose group and 98 were in the high\u2010dose group. There was significant reduction in the annual number of admissions due to vaso\u2010occlusive crisis in both groups (P<\/jats:italic>\u00a0<\u00a00.001). However, the difference between the two groups was statistically insignificant (P<\/jats:italic>\u00a0>\u00a00.05). In addition, there was an observed clinical improvement regarding the acute chest syndrome (ACS<\/jats:styled-content>). Both groups had comparable significant improvements in their laboratory markers [e.g., hemoglobin (H<\/jats:styled-content>b), Mean Corpuscular Volume (MCV<\/jats:styled-content>), and absolute neutrophil count (ANC<\/jats:styled-content>)]. All 142 patients tolerated the treatment well. Reversible toxicities occurred in both low\u2010 and high\u2010dose groups.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>In SCD<\/jats:styled-content> patients, low\u2010dose regimen of HU<\/jats:styled-content> is a feasible option that ensured safety and yet did not affect efficacy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.12103","type":"journal-article","created":{"date-parts":[[2013,3,15]],"date-time":"2013-03-15T00:22:03Z","timestamp":1363306923000},"page":"519-524","source":"Crossref","is-referenced-by-count":18,"title":["Optimizing Hydroxyurea use in children with sickle cell disease: low dose regimen is effective"],"prefix":"10.1111","volume":"90","author":[{"given":"Sharef Waadallah","family":"Sharef","sequence":"first","affiliation":[{"name":"Department of Child Health Sultan Qaboos University Hospital Muscat Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Al\u2010Hajri","sequence":"additional","affiliation":[{"name":"Department of Child Health Sultan Qaboos University Hospital Muscat Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismail","family":"Beshlawi","sequence":"additional","affiliation":[{"name":"Department of Child Health Sultan Qaboos University Hospital Muscat Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aamir","family":"Al\u2010Shahrabally","sequence":"additional","affiliation":[{"name":"Department of Child Health Sultan Qaboos University Hospital Muscat Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Elshinawy","sequence":"additional","affiliation":[{"name":"Department of Child Health Sultan Qaboos University Hospital Muscat Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew","family":"Zachariah","sequence":"additional","affiliation":[{"name":"Department of Child Health Sultan Qaboos University Hospital Muscat Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surekha Tony","family":"Mevada","sequence":"additional","affiliation":[{"name":"Department of Child Health Sultan Qaboos University Hospital Muscat Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wafaa","family":"Bashir","sequence":"additional","affiliation":[{"name":"Department of Child Health Sultan Qaboos University Hospital Muscat Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulhakim","family":"Rawas","sequence":"additional","affiliation":[{"name":"Department of Child Health Sultan Qaboos University Hospital Muscat Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aqeela","family":"Taqi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Sultan Qaboos University Hospital Muscat Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zakiya","family":"Al\u2010Lamki","sequence":"additional","affiliation":[{"name":"Department of Child Health Sultan Qaboos University Hospital Muscat Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasser","family":"Wali","sequence":"additional","affiliation":[{"name":"Department of Child Health Sultan Qaboos University Hospital Muscat Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,4,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2011.09.012"},{"key":"e_1_2_6_3_1","first-page":"59","article-title":"Haemoglobinopathies encountered at Khoula Hospital, Oman","volume":"8","author":"Adly G","year":"2008","journal-title":"Sultan Qaboos Univ Med J"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2008.07097.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-12-257444"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1997.3173132.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V99.7.2297"},{"key":"e_1_2_6_8_1","first-page":"268","article-title":"Hydroxyurea increases fetal hemoglobin production in sickle cell anemia","volume":"97","author":"Platt OS","year":"1984","journal-title":"Trans Assoc Am Physicians"},{"key":"e_1_2_6_9_1","first-page":"1550","article-title":"Safety of hydroxyurea in children with sickle cell anemia: results of the HUG\u2010KIDS study, phaseI\/II trial. 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