The Multicenter Study of Hydroxyurea (MSH) in sickle cell anemia identified certain risk factors associated with an increased risk of mortality during the study period. The authors are from 21 academic medical centers in the United States and Canada.


Selection for enrollment: > 3 painful episodes in the 12 months prior to enrollment and no contraindications to hydroxyurea therapy.


Risk factors associated with increased mortality:

(1) absolute reticulocyte count < 250,000 per µL and hemoglobin < 9 g/dL

(2) hemoglobin F levels < 0.5 g/dL

(3) one or more episodes of acute chest syndrome

(4) 3 or more painful episodes per year


Factors reducing the risk of mortality:

(1) taking hydoxyurea


To read more or access our algorithms and calculators, please log in or register.