A meta‐analysis of toxicities related to hydroxycarbamide dosing strategies

Abstract

Due to fear of short‐term toxicities, there is nonconsensus of hydroxycarbamide dosing strategy (escalated vs fixed‐dosing methods), which contributes to its suboptimal use. We performed a meta‐analysis to summarize the incidence rates of toxicities associated with both dosing methods. Summarized incidence rates could not be statistically compared between dosing methods due to sparse data. Summarized neutropenia and thrombocytopenia incidence rates were slightly higher when using escalated dosing than with fixed. Summarized reticulocytopenia was comparable. Summarized hepatic and renal toxicities’ incidence rates were slightly higher when using fixed doses than with escalated. We recommend diligent and transparent reporting of toxicities.

Intensive hydroxyurea dosing in very young children with sickle cell anemia

“…Regarding hydroxyurea toxicity, a meta-analysis found that neutropenia was more frequent with MTD dosing. 14 We noted increased neutropenia without an increase in significant infection in the intensive dose arm.…”