Growth and Puberty in African Children with Sickle Cell Anemia Treated with Hydroxyurea
Bibliographic record
Abstract
Abstract Children with sickle cell anemia (SCA) have poor growth and pubertal development. REACH (Realizing Effectiveness Across Continents with Hydroxyurea) is a prospective trial evaluating the feasibility, safety, and benefits of hydroxyurea at maximum tolerated dose (MTD) for children with SCA in sub-Saharan Africa. Children aged 1 to 10 years received open-label hydroxyurea with longitudinal follow-up. Height, weight, and pubertal staging were collected over 7 years of treatment. Biomarkers included insulin-like growth factor I (IGF-I), IGF-binding protein 3, luteinizing hormone, follicle-stimulating hormone, and anti-Mullerian hormone (AMH). Hydroxyurea commenced at an average (mean ± 1 standard deviation [SD]) age of 5.9 ± 2.4 years (range, 1.6-10.2) for girls (n = 296) and 5.4 ± 2.4 years (range, 1.3-10.1) for boys (n = 310). Using natural history SCA-specific reference curves, the mean weight-for-age z score improved from 0.47 ± 0.90 at enrollment to 0.69 ± 1.00 on hydroxyurea treatment. Height increased from 0.26 ± 0.90 to 0.42 ± 1.00 on treatment, and body mass index from 0.46 ± 1.00 to 0.85 ± 1.20. IGF-I remained low in many participants. Puberty was delayed in 25% to 30% of children, with gradual progress on treatment. AMH was low (<2.5th percentile) in 4% of girls, whereas 52% of boys had low AMH at baseline and 28% at follow-up. Long-term hydroxyurea treatment at MTD is associated with beneficial effects on growth with improved weight and height, and does not negatively affect pubertal developmenty in children with SCA in sub-Saharan Africa. This study was registered at www.clinicaltrials.gov initially as NCT01966731 and is now registered as NCT06171217 for long-term follow-up.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".