{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T10:51:32Z","timestamp":1791283892159,"version":"4.1.0"},"reference-count":57,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2008,12,1]]},"abstract":"<jats:p>CONTEXT. Hydroxyurea is the only approved medication for the treatment of sickle cell disease in adults; there are no approved drugs for children.<\/jats:p>\n               <jats:p>OBJECTIVE. Our goal was to synthesize the published literature on the efficacy, effectiveness, and toxicity of hydroxyurea in children with sickle cell disease.<\/jats:p>\n               <jats:p>METHODS. Medline, Embase, TOXLine, and the Cumulative Index to Nursing and Allied Health Literature through June 2007 were used as data sources. We selected randomized trials, observational studies, and case reports (English language only) that evaluated the efficacy and toxicity of hydroxyurea in children with sickle cell disease. Two reviewers abstracted data sequentially on study design, patient characteristics, and outcomes and assessed study quality independently.<\/jats:p>\n               <jats:p>RESULTS. We included 26 articles describing 1 randomized, controlled trial, 22 observational studies (11 with overlapping participants), and 3 case reports. Almost all study participants had sickle cell anemia. Fetal hemoglobin levels increased from 5%\u201310% to 15%\u201320% on hydroxyurea. Hemoglobin concentration increased modestly (\u223c1 g\/L) but significantly across studies. The rate of hospitalization decreased in the single randomized, controlled trial and 5 observational studies by 56% to 87%, whereas the frequency of pain crisis decreased in 3 of 4 pediatric studies. New and recurrent neurologic events were decreased in 3 observational studies of hydroxyurea compared with historical controls. Common adverse events were reversible mild-to-moderate neutropenia, mild thrombocytopenia, severe anemia, rash or nail changes (10%), and headache (5%). Severe adverse events were rare and not clearly attributable to hydroxyurea.<\/jats:p>\n               <jats:p>CONCLUSIONS. Hydroxyurea reduces hospitalization and increases total and fetal hemoglobin levels in children with severe sickle cell anemia. There was inadequate evidence to assess the efficacy of hydroxyurea in other groups. The small number of children in long-term studies limits conclusions about late toxicities.<\/jats:p>","DOI":"10.1542\/peds.2008-0441","type":"journal-article","created":{"date-parts":[[2008,12,1]],"date-time":"2008-12-01T14:23:01Z","timestamp":1228141381000},"page":"1332-1342","source":"Crossref","is-referenced-by-count":174,"title":["Hydroxyurea for Sickle Cell Disease: A Systematic Review for Efficacy and Toxicity in Children"],"prefix":"10.1542","volume":"122","author":[{"given":"John J.","family":"Strouse","sequence":"first","affiliation":[{"name":"Division of Pediatric Hematology, Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Lanzkron","sequence":"additional","affiliation":[{"name":"Divisions of Hematology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Catherine","family":"Beach","sequence":"additional","affiliation":[{"name":"General Internal Medicine, Department of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlton","family":"Haywood","sequence":"additional","affiliation":[{"name":"Departments of Health Policy and Management"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haeseong","family":"Park","sequence":"additional","affiliation":[{"name":"General Internal Medicine, Department of Medicine"},{"name":"Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Witkop","sequence":"additional","affiliation":[{"name":"General Preventive Medicine, Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renee F.","family":"Wilson","sequence":"additional","affiliation":[{"name":"General Internal Medicine, Department of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric B.","family":"Bass","sequence":"additional","affiliation":[{"name":"General Internal Medicine, Department of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jodi B.","family":"Segal","sequence":"additional","affiliation":[{"name":"General Internal Medicine, Department of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2008,12,1]]},"reference":[{"key":"2021120820193386300_R1","unstructured":"National Newborn Screening and Genetics Resource Center. National Newborn Screening Information System. Available at: www2.uthscsa.edu\/nnsis. Accessed November 7, 2007"},{"key":"2021120820193386300_R2","doi-asserted-by":"crossref","unstructured":"Makani J, Williams TN, Marsh K. Sickle cell disease in Africa: burden and research priorities. Ann Trop Med Parasitol.\u20082007;101(1):3\u201314","DOI":"10.1179\/136485907X154638"},{"key":"2021120820193386300_R3","unstructured":"Steiner CA, Miller JL. Sickle cell disease patients in U.S. hospitals, 2004. In: HCUP Statistical Brief. Rockville, MD: Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality; 2006"},{"key":"2021120820193386300_R4","doi-asserted-by":"crossref","unstructured":"Charache S, Barton FB, Moore RD, et al. Hydroxyurea and sickle cell anemia. Clinical utility of a myelosuppressive \u201cswitching\u201d agent. The Multicenter Study of Hydroxyurea in Sickle Cell Anemia. Medicine (Baltimore).\u20081996;75(6):300\u2013326","DOI":"10.1097\/00005792-199611000-00002"},{"key":"2021120820193386300_R5","doi-asserted-by":"crossref","unstructured":"Kato GJ, Gladwin MT, Steinberg MH. Deconstructing sickle cell disease: reappraisal of the role of hemolysis in the development of clinical subphenotypes. Blood Rev.\u20082007;21(1):37\u201347","DOI":"10.1016\/j.blre.2006.07.001"},{"key":"2021120820193386300_R6","doi-asserted-by":"crossref","unstructured":"Benkerrou M, Delarche C, Brahimi L, et al. Hydroxyurea corrects the dysregulated L-selectin expression and increased H2O2 production of polymorphonuclear neutrophils from patients with sickle cell anemia. Blood.\u20082002;99(7):2297\u20132303","DOI":"10.1182\/blood.V99.7.2297"},{"key":"2021120820193386300_R7","unstructured":"The management of sickle cell disease. In: Management of Sickle Cell Disease. 4th ed. Bethesda, MD: National Institutes of Health, National Heart, Lung, and Blood Institute, Division of Blood Diseases and Resources; 2002. NIH publication 02\u20132117"},{"key":"2021120820193386300_R8","unstructured":"Segal J, Strouse J, Beach M, et al. Hydroxyurea for the Treatment of Sickle Cell Disease Evidence Report. Washington, DC: Agency for Healthcare Research and Quality; 2008. AHRQ publication 08-E007"},{"key":"2021120820193386300_R9","doi-asserted-by":"crossref","unstructured":"Berlin JA. Does blinding of readers affect the results of meta-analyses? University of Pennsylvania meta-analysis blinding study group. Lancet.\u20081997;350(9072):185\u2013186","DOI":"10.1016\/S0140-6736(05)62352-5"},{"key":"2021120820193386300_R10","unstructured":"World Health Organization Collaborating Center for International Drug Monitoring. Causality assessment of suspected adverse reactions. Available at: www.who-umc.org\/DynPage.Aspx?Id=22682. Accessed December 16, 2007"},{"key":"2021120820193386300_R11","doi-asserted-by":"crossref","unstructured":"Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary?Control Clin Trials.\u20081996;17(1):1\u201312","DOI":"10.1016\/0197-2456(95)00134-4"},{"key":"2021120820193386300_R12","doi-asserted-by":"crossref","unstructured":"Horsburgh D. Evaluation of qualitative research. J Clin Nurs.\u20082003;12(2):307\u2013312","DOI":"10.1046\/j.1365-2702.2003.00683.x"},{"key":"2021120820193386300_R13","doi-asserted-by":"crossref","unstructured":"Lincoln TM, Rief W. How much do sample characteristics affect the effect size? An investigation of studies testing the treatment effects for social phobia. J Anxiety Disord.\u20082004;18(4):515\u2013529","DOI":"10.1016\/S0887-6185(03)00040-9"},{"key":"2021120820193386300_R14","doi-asserted-by":"crossref","unstructured":"Tobin GA, Begley CM. 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