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: To the Editor: Increases in the production of fetal hemoglobin can ameliorate the severity of both sickle cell disease and [beta]-thalassemia. Three groups of agents are known to increase the production of fetal hemoglobin in humans: cytotoxic drugs,1,2 growth factors,3 and agents that induce differentiation, such as butyrate.4 The clinical application of these drugs has been hindered by dose-limiting myelotoxicity or the requirement for continuous intravenous infusion. These difficulties may now be overcome through the exploitation of the recent discovery of sodium phenylacetate as a nontoxic inducer of differentiation affecting fetal hemoglobin production.5

Sodium phenylacetate and its pro-drug, sodium 4-phenylbutyrate, [horizontal ellipsis]

Owned, published, and (C) copyrighted, 1992, by the MASSACHUSETTS MEDICAL SOCIETY