This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on Web of Science (1)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Drug Therapy  • Adverse Effects  • Hematology/ Hematologic Malignancies  • Anemias  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: In their observational study, Dr Steinberg and colleagues¹ concluded that hydroxyurea is associated with a lower risk of myelodysplasia and acute leukemia among patients with sickle cell anemia (SCA) than among those with myeloproliferative diseases.

I am concerned, however, that the authors did not follow up the patients for long enough to detect such adverse effects of hydroxyurea. Although the mean follow-up was 7.6 years, most of the patients received hydroxyurea for less than 37 months. Furthermore, only 94 patients received it for 5 or more years. By contrast, Najean and Rain² found that among elderly individuals with polycythemia vera, the risk of acute leukemia was not significantly increased until after 8 years of continuous use of hydroxyurea. In the study of Steinberg et al, only 23 patients received hydroxyurea for at least 8 years.

I am aware of only 3 cases of acute leukemia in patients . . . [Full Text of this Article]

Derrick W. Spell, MD
Earl K. Long Medical Center
Louisiana State University Health Sciences Center
Baton Rouge

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Long-term Use of Hydroxyurea for Sickle Cell Anemia
Lawrence Feldman, Sandra Allen, Maxwell Westerman, Lori Feldman, Alice Gilman-Sachs, and Kenneth Beaman
JAMA. 2003;290(6):752-753.
EXTRACT | FULL TEXT  

Long-term Use of Hydroxyurea for Sickle Cell Anemia
Ward Hagar
JAMA. 2003;290(6):753.
EXTRACT | FULL TEXT  

Long-term Use of Hydroxyurea for Sickle Cell Anemia
Dean Anthony Lee and Brigitta U. Mueller
JAMA. 2003;290(6):753-754.
EXTRACT | FULL TEXT  

Long-term Use of Hydroxyurea for Sickle Cell Anemia—Reply
Martin H. Steinberg, Franca Barton, Michael Terrin, Myron Waclawiw, and Duane Bonds
JAMA. 2003;290(6):754.
EXTRACT | FULL TEXT  

Effect of Hydroxyurea on Mortality and Morbidity in Adult Sickle Cell Anemia: Risks and Benefits Up to 9 Years of Treatment
Martin H. Steinberg, Franca Barton, Oswaldo Castro, Charles H. Pegelow, Samir K. Ballas, Abdullah Kutlar, Eugene Orringer, Rita Bellevue, Nancy Olivieri, James Eckman, Mala Varma, Gloria Ramirez, Brian Adler, Wally Smith, Timothy Carlos, Kenneth Ataga, Laura DeCastro, Carolyn Bigelow, Yogen Saunthararajah, Margaret Telfer, Elliott Vichinsky, Susan Claster, Susan Shurin, Kenneth Bridges, Myron Waclawiw, Duane Bonds, and Michael Terrin
JAMA. 2003;289(13):1645-1651.
ABSTRACT | FULL TEXT