Hydroxyurea Treatment in Transfusion-Dependent β-Thalassemia Patients

Background: beta-Thalassemia is an inherited hemoglobin disorder caused by defective synthesis of ss-globin chains. Hemoglobin (Hb) F induction is a possible therapeutic approach which can partially compensate for alpha and non-alpha globin chains imbalance. Objectives: We aimed to investigate the efficacy and safety of Hydroxyurea (HU) in diminishing transfusion requirements of patients with beta-thalassemia major in Southern Iran. Patients and Methods: In this single-arm clinical trial, all transfusion-dependent beta-thalassemia patients older than two years old (n = 97) who had inclusion criteria of the study and had been registered for at least six months in Dastgheib thalassemia outpatient clinic (a referral center affiliated to Shiraz University of Medical Sciences) were evaluated from October 2010 to December 2011. The patients were treated with HU with a mean dose of 10.5 mg/kg for a mean duration of 8 months (range 3-14 months). Transfusion needs and Hb levels were compared before and after HU treatment. Results: The mean volume of blood transfusion decreased significantly following HU treatment (0.71 mL/kg/day vs. 0.43 mL/kg/day, P < 0.001). Two-thirds of the patients showed good and partial response. No serious adverse reaction was observed except persistent neutropenia in two patients. Conclusions: Hydroxyurea can be safely used in some transfusion-dependent beta-thalassemia patients to decrease their transfusion needs.