the influence of fetal hemoglobin on clinical and hematological variables of children and adolescents with sickle cell anemia in basra, southern iraq

background: there are many parameters that modulate the severity of sickle cell anemia. fetal hemoglobin (hb f) is one of these major variables. however, its effect is clinically inconsistent. we conducted a descriptive study to assess the influence of hb f on clinical events and hematological variables in patients with sickle cell anemia. methods: 151 patients with sickle cell anemia with a stable condition, aged 1-18 years, were recruited from march through november 2010. the results of complete blood count and hb f level and various clinical variables were recorded. results: of the 151 patients, the hb f was more than 20%, 10-20%, and less than 10% in 77 (51%), 60 (39.7%), and 14 (9.3%) patients. a significant negative association was reported between hb f level and frequency of painful crisis (95% ci=0.05-0.96, or=0.22), acute chest syndrome (95% ci=0.01-0.43, or=0.07) and frequency of hospitalizations (95% ci=0.03-0.85, or=0.11). there was a significant positive association between hemoglobin level (95% ci=2.14-27.17, or=7.63) and splenomegaly (95% ci=1.37-57.4, or=12.88) with hb f level. conclusion: in children and adolescents with sickle cell anemia, the higher the hb f levels, the lesser clinical complications of the disease would be. therefore, patients with low hb f need close follow-up and monitoring since early age to detect complications as early as possible and consider use of disease modifying agents.