Effect of Combination of Hydroxyurea and Iron Chelation Therapy on Leukocyte DNA Damage in Sickle Cell Anemia Patients

Abstract

Background: Multiple organ damage has been exhibited among patients with Sickle Cell Disease due to repeated vascular occlusion, which is superimposed on a background of failure and poor development. The burden of sickle cell anemia has been potentially associated to the high prevalence of consanguineous marriages in Saudi Arabia. The aim of this study was to evaluate the effect of combination between Hydroxyurea and iron chelation therapy on the degree of DNA damage. Methods: Between September 2017 and May 2018, 96 of homozygous sickle cell anemia patients and 24 healthy controls were enrolled in the study, aged between 10-40 years. All participants were visitors of the Haematology clinic and Day Care Unit at King Abdulaziz University Hospital, Jeddah Saudi Arabia who have been diagnosed with SCA disease. The experimental groups were divided into five groups: Healthy, SCA patients who do not take any medications, SCA patients who are taking Hydroxyurea only, SCA patients who take iron-chelating agents and SCA patients who take Hydroxyurea medication with iron chelating agents. Findings: The results give a significant decrease (P<0.000) in DNA damage in patients taking Hydroxyurea with iron chelating agents compared with patients taking Hydroxyurea only (1.32 ± 1.51 and 6.36 ± 2.36; respectively). The fetal hemoglobin (HbF) levels of both of the patient treated with Hydroxyurea and iron chelating agent samples were considerably higher than all other groups while the positive control SCA patients group was having the least amount. Patients who subjected to Hydroxyurea and/or chelating agents have the least counts among all of the groups in terms of RBC's counts. When compared to the normal group, Eosinophils and lymphocytes have the greatest amount in SCA patients treated with iron chelating agent only and SCA patients treated with Hydroxyurea and iron chelation therapy compared to the normal and SCA patients who were subjected to Hydroxyurea treatment only groups; whereas, the SCA patients treated with iron chelating agent only and SCA patients treated with Hydroxyurea and iron chelation therapy. got raised in levels. Interpretation: The correlation of increasing levels of WBCs and SCD have been proved on a biological basis. Funding Statement: This research is not funded by any resource. Declaration of Interests: Dr. Helmi has nothing to disclose., and the author declares no competing interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Ethics Approval Statement: Signed consent forms were obtained from all patients and controls according to Ethics Committee guidelines protocol by the Ministry of Health in Saudi Arabia (H-02-J-002). Written informed consent was obtained from all patients and controls in accordion with the guidelines of the Ethics Committee at King Abdul Aziz University Hospital. With Ethical approval number 151- 17.