Anusha Battina, Snehalata Gajbhiye, Chaitali Chindhalore, Ganesh Natthuji Dakhale, Apurva Bhoyar, Amol Dube, Sunita Kumbhalkar, Vishvdeep Khushoo, Richa Juneja
HU may exert therapeutic benefit not only by increasing HbF but also through anti-inflammatory and antioxidant effects, leading to improved hematological stability and fewer complications in SCD.
BACKGROUND AND OBJECTIVES: Sickle cell disease (SCD) is characterized by chronic hemolysis, inflammation, oxidative stress, and recurrent vaso-occlusive complications leading to significant morbidity. Hydroxyurea (HU), a widely used disease-modifying therapy, increases fetal hemoglobin (HbF) and reduces clinical complications. Emerging evidence suggests additional anti-inflammatory and antioxidant effects. The objectives of this study were to compare the inflammatory markers, oxidative stress markers, hematological parameters, and quality of life from baseline to 6 months after HU therapy among patients with SCD.
MATERIALS AND METHODS: In this prospective observational study, 16 HU-naïve patients with SCD were evaluated at baseline and after 6 months of HU therapy. Investigations included inflammatory markers (interleukin-6 [IL-6] and tumor necrosis factor-alpha [TNF-α]), oxidative stress markers (malondialdehyde [MDA] and glutathione [GSH]), hematological parameters (HbF, sickle hemoglobin [HbS], leukocyte count, and neutrophil-to-lymphocyte ratio [NLR]), and quality of life assessed using the 36-Item Short Form Health Survey questionnaire.
RESULTS: Significant reductions in inflammatory markers were observed, with TNF-α decreasing from 5.82 ± 2.82 pg/mL to 4.64 ± 2.65 pg/mL (P = 0.006) and median IL-6 levels decreasing from 6.32 to 4.42 pg/mL (P = 0.001). Oxidative stress improved, with reduced MDA levels (P = 0.011) and increased GSH levels (P = 0.001). Hematological parameters showed significant improvement, including increased HbF and reductions in HbS, leukocyte count, and NLR (P < 0.001). HU therapy was well tolerated, with good compliance, improved quality of life, and a low incidence of complications.
CONCLUSION: HU may exert therapeutic benefit not only by increasing HbF but also through anti-inflammatory and antioxidant effects, leading to improved hematological stability and fewer complications in SCD.