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The Mean Corpuscular Volume and Hydroxyurea in Brazilian Patients with Sickle Cell Anemia: A Surrogate Marker of Compliance | OMICS International | Abstract
ISSN: 2155-9864

Journal of Blood Disorders & Transfusion
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Research Article

The Mean Corpuscular Volume and Hydroxyurea in Brazilian Patients with Sickle Cell Anemia: A Surrogate Marker of Compliance

Ana Maria Mach Queiroz1, Clarisse Lopes de Castro Lobo1, Emilia Matos do Nascimento2, Basilio de Bragança Pereira2,3, Claudia Regina Bonini-Domingos4, Gilberto Perez Cardoso5 and Samir K Ballas6*

1HEMORIO-State Institute of Hematology Arthur de Siqueira Cavalcanti, Rio de Janeiro, Brazil

2Federal University of Rio de Janeiro, COPPE - Postgraduate School of Engineering, Rio de Janeiro, Brazil

3Federal University of Rio de Janeiro-School of Medicine, Rio de Janeiro, Brazi

4UNESP - Sao Paulo State University, Department of Biology, Hemoglobin and Hematologic Diseases Genetic Laboratory, São Paulo, Brazil

5UFF - Fluminense Federal University, Department of Clinical Medicine, School of Medicine, Niterói, Brazil

6Cardeza Foundation, Department of Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA, USA

*Corresponding Author:
Samir K. Ballas
Cardeza Foundation for Hematologic Research
1020 Locust Street, Philadelphia, PA 19107, USA
Tel: 856-745-6380
Fax: 856-795-0809
E-mail: [email protected]

Received date: August 21, 2013; Accepted date: September 18, 2013; Published date: September 21, 2013

Citation: Queiroz AMM, de Castro Lobo CL, do Nascimento EM, de Bragança Pereira B, Bonini-Domingos, et al. (2013) The Mean Corpuscular Volume and Hydroxyurea in Brazilian Patients with Sickle Cell Anemia: A Surrogate Marker of Compliance. J Blood Disord Transfus 4:157. doi: 10.4172/2155-9864.1000157

Copyright: © 2013 Queiroz AMM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


The suppression of erythropoiesis by Hydroxyurea (HU) therapy is associated with increase in mean corpuscular volume, in addition to the increase in Hb F. Monitoring the mean corpuscular volume values and the presence of macrocytosis are effective tools of adherence to the treatment with HU in patients with sickle cell anemia. The aim of this study is to monitor the mean corpuscular volume values after starting treatment with HU to determine if macrocytosis can be used as a surrogate marker of compliance with therapy. We conducted a prospective cohort study over one year with measurements of blood counts and mean corpuscular volume after starting therapy with HU in 95 patients with sickle cell anemia who were regularly followed in our ambulatory outpatient unit. In one-year of successful use of HU the mean value of the mean corpuscular volume increased significantly. The Andersen and Gill model demonstrated that the increase of one unit of MCV implies a 5% reduction in the risk of visiting the emergency room. Monitoring mean corpuscular volume values after prescribing HU alerts the provider of noncompliance in order to counsel the patient in question for better adherence to the use of HU that could improve the quality of care and to reduce morbidity and the frequency of acute pain crises and associated healthcare costs.


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