{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:50:58Z","timestamp":1790884258933,"version":"4.1.0"},"reference-count":31,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Pediatr"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Sickle cell disease (SCD) is characterized by a chronic hypercoagulable state. Hydroxyurea (HU) is known to reduce the frequency of vaso-occlusive events and transfusion requirements in affected individuals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To assess the impact of hydroxyurea on biomarkers of coagulation (D-dimer) and endothelial activation (soluble VCAM-1) in SCD patients in Pakistan in their steady state.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A prospective observational study was conducted in patients aged\u2009\u2a7e\u200910\u2009years with confirmed HbSS or HbS\u03b2-thalassemia genotypes. Biomarkers were measured at baseline and after 6\u2009months of HU therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Twenty-five patients (HbSS\u2009=\u200915 [60%], HbS\u03b2-thalassemia\u2009=\u200910 [40%]) with a median (IQR) age of 23 (16.5-27) years were enrolled. A significant decrease in D-dimer levels was observed after HU treatment: from a median of 1243 to 830\u2009ng\/mL (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.028), reflecting a 33% reduction. Soluble VCAM-1 levels showed no statistically significant change (532.6 vs 492.9\u2009ng\/mL,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.381). HbF increased from 20.1% (12.6-27.5) to 28% (20-39) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), with a strong positive correlation with HU treatment (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      \u2009=\u2009.845).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study demonstrates that HU therapy in Pakistani SCD patients significantly reduces D-dimer levels, suggesting reduced thrombotic activity. While the endothelial marker VCAM-1 showed no significant change, the rise in HbF is consistent with known HU effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11795565251403177","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T11:06:41Z","timestamp":1773227201000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Hydroxyurea in Sickle Cell Disease: Coagulation and Activation in an Observational Study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7867-1275","authenticated-orcid":false,"given":"Munira","family":"Borhany","sequence":"first","affiliation":[{"name":"National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafiza Tuba","family":"Iqbal","sequence":"additional","affiliation":[{"name":"National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madiha","family":"Abid","sequence":"additional","affiliation":[{"name":"National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sidra","family":"Zafar","sequence":"additional","affiliation":[{"name":"National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/2331205X.2016.1188875"},{"key":"e_1_3_3_3_2","volume-title":"Executive Board 118th Session: Thalassemia and Other Haemoglobinopathies","author":"World Health Organization","year":"2006","unstructured":"World Health Organization. Executive Board 118th Session: Thalassemia and Other Haemoglobinopathies. WHO; 2006. 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Placenta growth factor in sickle cell disease: association with hemolysis and inflammation. Am J Hematol. 2010;115(10):2014-2020.","journal-title":"Am J Hematol"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1067\/mlc.2001.115450"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V97.11.3628"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1992.tb02989.x"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V91.11.4216"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1998.01121.x"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00282-996-0279-2"},{"issue":"2","key":"e_1_3_3_26_2","first-page":"169","article-title":"Enhanced thrombin generation in children with sickle cell disease","volume":"71","author":"Peters M","year":"1994","unstructured":"Peters M, Plaat BE, ten Cate H, Wolters HJ, Weening RS, Brandjes DP. 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