Hydroxyurea Use in Sickle Cell and Other Conditions
More Programs and Publications Featuring Maya Bloomberg, MSN, APRN
In this program:
What do sickle cell patients need to know about hydroxyurea? Hematology nurse practitioner Maya Bloomberg from Sylvester Comprehensive Cancer Center explains the history of hydroxyurea use and how it can help in sickle cell care.
Transcript
Interviewer:
Is hydroxyurea (Hydrea) a drug that's commonly used outside of a hematologist office or outside of even an oncologist office? Like let's say in an environment where a lot of sickle cell patients may be like in an emergency room. Is that really something that's ever prescribed in those settings where patients will even be aware that it exists and it's a drug that is useful for them?
Maya Bloomberg, MSN, APRN:
Yeah, so hydroxyurea is the standard of care when it comes to managing sickle cell. I always laugh when I have a patient who's in the hospital and they'll start hydroxyurea during that admission when in reality this is a medication that needs to be taken consistently to have that maximum benefit. So individuals who have hemoglobin SS, which is kind of your textbook sickle cell, that's the one that's characterized by rapid hemolysis or red cell breakdown, a lot of anemia and more complications, sickle beta-thalassemia zero presents very similarly to hemoglobin SS, that's going to be somebody who really should be on hydroxyurea. The problem is, is that it was initially created as an oncology or a chemo drug. We started studying it, but in the mid '80s and in 2003 is when we had enough data to show that this medication saves lives and reduces mortality and we literally put babies on it at the age of six, nine months old because the benefits are so overwhelming. But, unfortunately, since it wasn't created specifically for sickle cell and it's a chemo drug, there are a lot of people who are hesitant to take the medication. So luckily with a lot of research and different treatments in the pipeline, we're starting to have other options and can utilize shared decision-making where when I first started my career 10 years ago, all I had was hydroxyurea and blood transfusions.
So I think hydroxyurea is known because it's been around since the mid to late '80s. And again, it really is the standard of care. So if you have hemoglobin SS and S beta-thal zero, you really should consider this because it's going to help protect your organs, it's going to raise your hemoglobin. It reduces the risk of acute chest syndrome, which is the number one cause of death in sickle cell, it reduces your transfusion need. So there really are a lot of benefits, but there are some risks. So I understand why my patients might be hesitant, but I use it more as an opportunity to have a conversation and a meaningful dialogue as opposed to just eliminating it as an option for them.
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