DNA damage in blood leukocytes of individuals with sickle cell disease treated with hydroxyurea

Hydroxyurea (HU) plays an important role in the treatment of patients with sickle cell disease (SCD). Although HU has been associated with an increased risk of leukemia in some patients with myeloproliferative disorders, the mutagenic and carcinogenic potential of HU has not been established. This study investigated levels of DNA damage using the alkaline (pH > 13) comet assay to analyze peripheral blood leukocytes sampled from 28 patients with SCD treated with HU (SCHU) and from 28 normal individuals. The damage index (DI) in the SCHU group was significantly higher than in controls (p < 0.05). Gender, smoking or age were not associated with DNA damage in controls or SCHU individuals. In the group of SCHU individuals, mean HU dose and DI were positively correlated, and individuals who received a mean dose of >20 mg/kg HU (DI = 24.9 ± 5.5) showed significantly more DNA damage than those who received ≤20 mg/kg HU (DI = 14.6 ± 1.8) (p < 0.05). Individuals treated for ≥42 months (DI = 23.1 ± 4.2) showed significantly greater DNA damage than those treated for <42 months (13.6 ± 1.9) (p < 0.05). DI was inversely correlated with body mass index in the SCHU group.