Despite benefits in reducing pain crises, transfusions, hospitalizations, and mortality in sickle cell disease (SCD),1-5 hydroxyurea (HU) is underutilized.1,6,7 A recent Cochrane meta-analysis found no significant increase in adverse events among HU-treated patients with SCD,8 yet fears of possible adverse effects have been identified as a key barrier to HU acceptance.9-11 In light of the poor uptake of HU among the SCD population, hematologists need to fully understand patient and provider reluctance about this disease-modifying therapy.
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