Hydroxyurea maximum dose colospa

Overall laboratory response to hydroxyurea was superior in our cohort to that seen in the BABY HUG treatment arm, but MTD declined with age of initiation of treatment. Even in malaria endemic regions, hydroxyurea is safe and has been shown to reduce vaso-occlusive events and lower mortality.

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Hydroxyurea is recommended for the treatment of children who have sickle cell anemia (SCA), but optimal dosing of the drug has been a matter of controversy. Hydroxyurea has the potential to enhance . Statistical modeling showed that a patients’ odds of being hospitalized ranged from 2- to 4-fold higher when the patient’s HbF was at or below 20%.Moderate neutropenia occurred in 14% of participants and in 2% of all evaluable time intervals. The patients were evaluated every 4 to 6 weeks during initiation, and every 8 to 12 weeks after having achieved MTD, for up to 4 years of follow-up.The researchers concluded that most children with SCA treated with hydroxyurea can safely achieve and maintain HbF levels above 20% when they are escalated to MTD, and children who maintain these levels have fewer SCA-related complications that require hospital admission.“These data support a dosing strategy for hydroxyurea that produces HbF levels above 20% to decrease hospitalizations in children with SCA, with this value serving as clinically meaningful endpoint for future trials and clinical practice,” the authors wrote.Hydroxyurea therapy escalated to MTD resulted in a median HbF of 21.7% (range, 16.2 to 27.8%).Compared to laboratory parameters when patients reached MTD, HbF, hemoglobin, mean corpuscular volume, absolute reticulocyte count, absolute neutrophil count, and platelet counts were maintained and were not significantly altered following 1, 2, 3, and 4 years of therapy.Patients experienced a median 1 (range, 0 to 43) hospitalization during the study period, with the most common reason for sickle cell-related admission being vaso-occlusive pain. Hydroxyurea for SCA increases hemoglobin F and reduces pain crises, acute chest syndrome and blood transfusions. The optimal dosing regimen is not known, however, and specifically whether a fixed dose at 15-20 mg/kg/day is better than escalation to maximum tolerated dose (MTD) at 25-30 mg/kg/day.







Most young patients reach a maximum tolerated dose of hydroxyurea at 25–30 mg/kg/day, where they will achieve key laboratory thresholds (Hb ≥9 g/dL and HbF ≥20%) without excessive myelosuppression.

to tissues; it can also induce a recall phenomenon in previously irradiated tissue.

Patients had either already initiated hydroxyurea therapy, or began therapy at the study’s outset at a dose of 20 mg per kg per day and (increased by 5 mg per kg every 8 to 12 weeks to MTD). The BABY HUG trial of hydroxyurea in very young children with sickle cell anemia (SCA) established the safety and clinical benefit of hydroxyurea therapy at a fixed dose in this age group but did not assess the safety and efficacy of escalation to maximum tolerated dose (MTD) in this age group.To address this question, we conducted a retrospective chart review of children with HbSS or HbS βWe identified 102 patients ranging from 5 to 24 months in age initiated on hydroxyurea therapy during the study period. MTD was achieved in 86 patients, of whom 51 were still at MTD at the end of monitoring. 50 to 100 mg/kg (Max dose: 6 g) PO daily until the blast cell count decreased to less than 100,000/mm3 was studied in 9 adult patients with acute leukemia, including 7 patients with acute myeloid leukemia. Plasma hydroxyurea clearances were not a useful guide to maximum tolerated doses of the drug. Objective.

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