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Cancer drug benefits sickle cell patientsStudy indicates 'new hope for these patients'
CHICAGO, Illinois (AP) -- Sickle cell anemia patients afflicted with repeated bouts of disabling pain will live longer if given a potent drug already shown to help them feel better, a study suggests.
Some 30 percent of sickle cell patients have the excruciating episodes, yet few are prescribed hydroxyurea, a drug also used in cancer and AIDS treatment, the researchers said. Adult patients who used hydroxyurea capsules at least periodically for nine years were 40 percent less likely to die during the study than those who never used the drug. "Now there is new hope for these patients, who typically die 10 to 15 years earlier than patients with milder cases," said Dr. Claude Lenfant, director of the National Heart, Lung and Blood Institute, which funded the research. The study appears in Wednesday's Journal of the American Medical Association. It is a follow-up of research from 1992-95 on 299 patients that showed the drug effectively treats painful symptoms. Complete data were available for 233 patients tracked through May 2001. Sickle cell anemia, an inherited blood disorder, affects about 72,000 Americans, mostly blacks. Patients have defective hemoglobin, oxygen-carrying blood protein, which causes deformed red blood cells that can clog vessels. This deprives organs and tissues of adequate blood supply, causing severe pain. Hydroxyurea reduces painful episodes by increasing levels of a type of hemoglobin that improves blood flow. There were 13 deaths among the 36 patients who never took hydroxyurea, compared with 21 deaths among the 106 patients who took the drug throughout the nine-year period. The 40 percent difference was calculated using an average of death rates for every three-month period in the study, said Dr. Duane Bonds of the national institute, a study co-author. The drug costs about $100 monthly. There are possible side effects, including a potentially increased risk of leukemia and a decrease in blood cell counts, which could make patients prone to infections. None of the study participants developed leukemia, and blood cell decreases can be managed with proper monitoring, said Dr. Martin Steinberg of Boston University, the lead researcher. Bonds said the potent drug may be underused because it's "more work for doctors," requiring frequent patient visits to adjust dosages and make sure complications don't develop. "Patients should be reassured," Bonds said. "This is an effective and safe therapy." Dr. Michael Levien, a pediatric hematologist at Cleveland Clinic Foundation, said the study's results are significant and should encourage expanded use of hydroxyurea. "It's a very, very important drug. It just has to be used properly," Levien said. Patients are generally advised to take the capsules daily. Study participants took either hydroxyurea or dummy pills in the first phase. In the follow-up, from 1996-2001, researchers observed results in patients who continued, stopped or started taking hydroxyurea. Copyright 2003 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
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