Open AccessEffect of Sickle Cell Anemia Therapies on the Natural History of Growth and Puberty Patterns
Author(s) -
Vishnu Nagalapuram,
Varsha Kulkarni,
Justin M. Leach,
Inmaculada Aban,
Krishnaveni Sirigaddi,
Jeffrey D. Lebensburger,
Pallavi Iyer
Publication year - 2019
Publication title -
journal of pediatric hematology/oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.388
H-Index - 78
eISSN - 1536-3678
pISSN - 1077-4114
DOI - 10.1097/mph.0000000000001477
Subject(s) - medicine , sickle cell anemia , anthropometry , transfusion therapy , pediatrics , anemia , linear growth , growth velocity , hemoglobinopathy , natural history , disease , blood transfusion , mathematics
As pediatric patients with sickle cell anemia (SCA) have impaired growth and puberty patterns, we studied the effect of disease-modifying therapies on growth and puberty patterns for patients with SCA receiving hydroxyurea (HU), transfusions, or no therapy. We performed a retrospective study of children with SCA in whom anthropometric measurements and therapy type were recorded. Penalized smoothing splines were fitted to estimate growth curves and growth velocity, and linear mixed models were used to examine differences across treatment groups. Across group analyses were divided into early childhood (4.0 to 7.9 y) and peripubertal (8.0 to 12.0 y). We analyzed growth data on 157 SCA patients. From 8.0 to 12.0 years, girls on transfusion therapy were significantly taller than girls on HU (range, 5.7 to 7.2 cm; P-value range 0.002 to 0.01). From 10.0 to 12.0 years, boys on transfusion therapy were significantly taller than boys on HU (range, 4.1 to 9.4 cm; P-value range <0.0001 to 0.04). In addition, boys on transfusion therapy had an earlier peak height velocity as compared with boys on either HU or no therapy. In conclusion, children receiving transfusions tended to be taller than children on HU or no therapy. Children on HU did not demonstrate superior growth pattern when compared with children on no therapy in the peripubertal years.