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

In Reply: We agree with Dr Spell that more follow-up is necessary to assess the risk of leukemia associated with hydroxyurea treatment for SCA. We plan to pursue 5 additional years of follow-up.

Like Dr Feldman and colleagues, we would be interested in CD4 and CD8 cell counts in patients with less clinically severe SCA.

Dr Hagar is concerned that the use of cocaine may account for substantial mortality among patients not taking hydroxyurea. However, this is not supported by 29 available case autopsies. Metabolites of cocaine were reported in only 2. We do not have enough data to estimate therapeutic window thresholds. Generalized estimating equation analyses indicate that hydroxyurea's effect on mortality is not changed in magnitude or direction by adjustment for baseline fetal hemoglobin, but such analyses have low statistical power.

Deaths not yet classified will ultimately be distributed over the specified causes. Neutrophil count was not associated . . . [Full Text of this Article]

Martin H. Steinberg, MD
Boston University School of Medicine
Boston Medical Center
Boston, Mass

Franca Barton, MS; Michael Terrin, MD, MPH
Maryland Medical Research Institute
Baltimore

Myron Waclawiw, PhD; Duane Bonds, MD
National Heart, Lung, and Blood Institute
Bethesda, Md

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