Treatment of homozygous sickle cell disease with pentoxifylline

This case report describes the sustained symptomatic and hematologic improv ement in a 21-year-old woman with homozygous sickle cell (ss) disease durin g treatment with pentoxifylline, 400 mg three times daily after meals. Pain crises decreased from six to zero per year, hemoglobin level rose from 8.4 g/dL to 11.4 g/dL, hematocrit rose From 24.8% to 34.8%, lactate dehydrogen ase level decreased from 375 IU/L to 322 IU/L, and total bilirubin level de creased from 1.8 mg/dL to 1.6 mg/dL. Mean corpuscular hemoglobin increased From 21.6 pg to 30 pg and mean corpuscular hemoglobin concentration increas ed from 24.1 g/dL to 34.5 g/dL. These changes were sustained for seven year s except for a brief self imposed hiatus in therapy during which period a p ain crisis occurred. Further increase in pentoxifylline dosage to 400 mg fo ur times daily did not result in any further improvement in these hematolog ic parameters. These results suggest that pentoxifylline reduces hemolysis in SS patients with a resulting improvement in anemia and a reduction in or elimination of pain crises.