Clinical and Biological Profile of Patients Treated with Hydroxyurea at the Mother and Child Center of Chantal Biya Foundation

ABSTRACT Introduction. In Cameroon, sickle cell disease (SCD) remains a concerning condition, with a high proportion of severe forms that require intensification of treatment. Unfortunately, exchange transfusion is not practiced to date and hydroxyurea (HU) remains sparsely prescribed. There are very few studies evaluating the efficacy of HU in our context. We therefore undertook the present study to evaluate efficacy of HU on the clinical and biological profile of SCD children in Yaounde, Cameroon. Patients and methods. We did a retrospective cohort study including all sickle cell children aged 2 to 20 years, regularly followed-up at our center, and placed on HU for at least one year before the start of the study. We analyzed clinical data (transfusion needs, frequency of vaso occlusive crisis, serious complications), hemolysis and medullary activity indicators and hemoglobin level before and after initiation of HU with a 12 months follow up. Adverse effects were noted. Results. We included 30 patients with homozygous SCD from which 56.7% male. The median age was 96 months (IQR 72-142.5). The main indication of HU was a low basal hemoglobin level (46.7%), followed by severe vaso-occlusive crises leading to at least three hospitalizations per year (40.0%). At 12 months, we noticed a reduction of 90% of admissions and a reduction of duration of hospitalization. Significant increase of weight gain (pl 0.001) and improvement of hemoglobin level. (pl0.001). Few mild adverse effects were reported. Conclusion. Hydroxyurea improves clinical and hematological parameters of children and adolescents in MCC/CBF at 12 months. RESUME Introduction. Au Cameroun, la drepanocytose demeure un probleme de sante publique avec une grande proportion de formes severes necessitant un traitement intensif. Malheureusement l’echange transfusionnel n’est pas encore pratique et l’hydroxyuree (HU) est peu prescrit. Peu d’etudes ont evalue l’efficacite de ce dernier dans notre contexte. Ceci justifie le present travail dont le but etait d’evaluer l’efficacite clinique et biologique de l’HU chez des enfants drepanocytaires a Yaounde, Cameroun. Patients et methodes Nous avons realise une etude de cohorte retrospective incluant des drepanocytaires âges de 2 a 20 ans, sous HU depuis au moins 12 mois consecutifs, suivis dans notre centre. Nous avons analyse leurs donnees cliniques de severite de la maladie, les indicateurs d’hemolyse et d’activite medullaire et le taux d’hemoglobine a l’initiation de l’HU et a 12 mois de suivi. Les effets secondaires etaient notes. Resultats. Nous avons inclus 30 patients drepanocytaires homozygotes dont 17(56,7%) etaient des garcons. L’âge median etait de 96 mois (EIQ 72-142,5). Les principales indications de mise sous HU etaient le taux d’hemoglobine bas (46,7%) et les crises vaso occlusives severes (40%) entrainant au moins 3 hospitalisations annuelles. Apres 12 mois, nous avons note une reduction de 90% des hospitalisations ainsi que la duree d’hospitalisation. Nous avions une prise de poids significative (pl 0.001) ainsi que l’augmentation du taux d’hemoglobine (pl 0.001). Quelques effets secondaires mineurs ont ete rapportes. Conclusion. L’hydroxyuree ameliore les parametres cliniques et biologiques des enfants et adolescents drepanocytaires au Centre Mere Enfant de la Fondation Chantal Biya.