Hydroxyurea and sickle cell crisis

To the Editor: Charache et al. (May 18 issue)¹ reported on the efficacy of hydroxyurea in ameliorating some of the complications of sickle cell anemia. In a randomized, double-blind setting, hydroxyurea treatment was associated with a reduced frequency of vaso-occlusive crises, acute chest syndrome, and transfusions, but not of stroke, hepatic sequestration, or death. As the authors emphasized, the encouraging results of this study must be balanced by concern over the carcinogenic or leukemogenic potential of long-term hydroxyurea therapy. In an accompanying editorial, Schechter and Rodgers² state, “There has been extensive experience with [hydroxyurea's] long-term use – at slightly higher.