Hydroxyurea for abnormal TCDs: Safe to switch?

Abstract

In this issue of Blood, Bernaudin et al report that chronic red blood cell transfusions can be safely replaced with hydroxyurea therapy or bone marrow transplantation for a cohort of children with sickle cell anemia (SCA) and abnormal transcranial Doppler (TCD) velocities.1 These data nicely complement the recently published results from the phase 3 multicenter TCD With Transfusions Changing to Hydroxyurea (TWiTCH) study and suggest that it may be safe to carefully transition a subset of patients from chronic transfusions to hydroxyurea therapy.2