Progressive Glioblastoma Multiforme in a Patient with Sickle Cell Beta Thalassemia, Observations Following Combining Valproic Acid with Hydroxyurea

Increased Fetal Hemoglobin (HbF) appears to ameliorate the clinical severity of sickle cell disease. Studies have shown that multiple short chain fatty acids can induce gamma globin expression with increased HbF production. There are no randomized trials evaluating the combination of valproic acid a short chain fatty acid and Hydroxyurea (HU), both of which can independently increase fetal HbF production. Here we report our observation in a sickle cell beta thalassemia patient with infrequent sickle cell pain episodes, who was diagnosed with Glioblastoma Multiforme (GBM), underwent treatment for this, with a drastic increase in the number and frequency of her sickle cell pain episodes that was subsequently placed on a drug regimen that included the combination of low dose HU and valproic acid.