Changes in Transcranial Doppler Flow Velocities in Children with Sickle Cell Disease: The Impact of Hydroxyurea Therapy

Changes in Transcranial Doppler Flow Velocities in Children with Sickle Cell Disease: The Impact of Hydroxyurea Therapy

Author Adegoke, Samuel Ademola Autor UNIFESP Google Scholar
Macedo-Campos, Rejane de Souza Autor UNIFESP Google Scholar
Pellegrini Braga, Josefina Aparecida Autor UNIFESP Google Scholar
Figueiredo, Maria Stella Autor UNIFESP Google Scholar
Silva, Gisele Sampaio Autor UNIFESP Google Scholar
Abstract Background and Objectives: Hydroxyurea (HU) was recently described as a substitute for chronic transfusion for children with sickle cell disease (SCD) and abnormal transcranial Doppler (TCD) velocities who have received at least 1 year of transfusions. However, the role of HU in reverting elevated TCD velocities in patients not treated with transfusion is still debatable. The objective of the study was to examine whether HU influences the progression of TCD velocities in children with SCD. Patients and Methods: Children with SCD with at least 2 TCDs not less than 6 months apart were evaluated over 51 months. Time-averaged maximum mean (TAMM) velocities for the initial and the last transcranial Doppler examinations were noted and differences compared between HU and HU-naive groups. Results: Overall, 68.8% of the HU-group with elevated TCD velocities compared with 40.0% of the HU-naive experienced TCD reversal (P = .047). A higher proportion of the HU-naive group, 7 (14.3%) versus 9.8% of the HU group experienced TCD conversion. Those with initial conditional velocities in the HU-group experienced a significant reduction in TAMM velocities (from 176.8 +/- 5.3 to 162.7 +/- 13.9 cm/s, difference of 14.1 cm/s

P = .001) unlike those in the HU-naive group (176.3 +/- 5.3 to 170.0 +/- 18.6 cm/s, difference of 6.3 cm/s

P = .148). The change in the TAMM velocities was also significantly higher among the HU-group (14.1 +/- 12.4 cm/s versus 6.3 +/- 18.5 cm/s, P = .015). Conclusion: Our data suggest a beneficial role of HU in TCD velocity reduction in patients not treated with chronic transfusions, particularly among those with initial conditional TCD velocities.
Keywords Children
chronic blood transfusions
hydroxyurea
sickle cell disease
transcranial Doppler
xmlui.dri2xhtml.METS-1.0.item-coverage Amsterdam
Language English
Date 2018
Published in Journal Of Stroke & Cerebrovascular Diseases. Amsterdam, v. 27, n. 2, p. 425-431, 2018.
ISSN 1052-3057 (Sherpa/Romeo, impact factor)
Publisher Elsevier Science Bv
Extent 425-431
Origin http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2017.09.020
Access rights Closed access
Type Article
Web of Science ID WOS:000419585800027
URI https://repositorio.unifesp.br/handle/11600/54236

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