Hemoterapia em pessoas com anemia falciforme em uso ou não de hidroxiureia

Abstract

Introduction: Hemotherapy and/or transfusion may be necessary to correct a sudden drop in hemoglobin level, or for prevention or recurrence of an event such as the first stroke. However, as the frequency of this therapy increases, it may lead to iron overload and organ dysfunction. Objective: To evaluate the effect of hemotherapy in patients with sickle cell anemia with or without the use of hydroxyurea. Material and methods: This is an observational, analytical cohort study with retrospective data in medical records of patients diagnosed with sickle cell anemia, homozygous (HbSS), attended at University Hospital Maria Aparecida Pedrossian, Regional Hospital of Mato Grosso do Sul, both in Campo Grande and at University Hospital of the Federal University of Grande Dourados in the city of Dourados, whose collection occurred from March to October 2019. The two stages of collection (before and after) occurred in the same patient. The variables collected and compared followed the established time periods: Before - four years before the use of hydroxyurea. The mean of the values obtained for each variable. After - four years after the use of hydroxyurea with the mean of the same variables. This period after use was divided into 1st; 2nd; 3rd; 40 years. The data collected in the "after", begin at the first medical prescription for hydroxyurea, which for each patient seen in the period from 1980 to 2019, has a specific date. Results: Of the 24 patients with sickle cell anemia participating in this cohort, median age of 33.33 (20 to 52) years, using hydroxyurea for four years, there was a good clinical response to the drug. Reduction soon after the first year of hydroxyurea use in terms of median, units of packed red blood cells transfused (from 6 vs 0; p < 0.001); frequency of number of admissions (from 4 vs 0; p <0.001) and time of hospital stay up to date (from 12 vs 0; p <0.001), and frequency of pain manifestation after vs four years of use, in median terms (from 4 to 2 episodes; p<0.001). There was a significant increasing increase, after the 1st, 2nd, 3rd and 4th years of treatment with hydroxyurea, in the mean concentration of Hemoglobin and Hematocrit. The VCM increased in the 4th year after the use of hydroxyurea. The mean white blood cell count decreased after the use of hydroxyurea, in the 1st, 2nd, 3rd and 4th years. Conclusion: After four years of HU use, there are improvements in the quality of life of patients with sickle cell anemia, evidenced by the reduced need for packed red blood cell transfusions, hospitalizations and days of hospital stay, in addition to a reduced number of pain episodes as well as an increase in Hb, Ht, and VCM and a decrease in leukocytes. It is recommended that medical records about the treatments be objective and systematic, to allow for future evaluations.