Fetal Hemoglobin Induction Treatment Metformin

Inclusion Criteria

• •1. Confirmed diagnosis of sickle cell anemia
• •2. Age greater than or equal to 10 and less than or equal to 60 years of age.
• •3. If on hydroxyurea, fetal hemoglobin less than 20% at a stable dose (mg/kg) determined by the primary hematology provider over at least four months.
• •4. Creatinine less than or equal to 1.4 mg/dL and estimated glomerular filtration rate greater than 45 ml/min/1.73 m2
• •5. Liver function tests (specifically ALT and conjugated bilirubin) less than or equal to 4 times upper limits of normal.
• •2. Simple or chronic red blood cell transfusion therapy in the last 3 months OR a HbA level greater than 5% in SCA patients
• •3. Refusal to use medically effective birth control if female and sexually active.
• •4. If on hydroxyurea, not at stable dose of hydroxyurea for a minimum of 4 months (temporary exclusion).
• •5. Creatinine greater than 1.4mg/dL
• •6. Liver function tests (ALT and conjugated bilirubin) greater than 4 times upper limits of normal.