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Treatment of polycythemia vera with hydroxyurea
Author(s) -
Donovan Paul B.,
Kaplan Manuel E.,
Goldberg Judith D.,
Tatarsky Ilana,
Najean Yves,
Silberstein Edward B.,
Knospe William H.,
Laszlo John,
Mack Karen,
Berk Paul D.,
Wasserman Louis R.
Publication year - 1984
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830170402
Subject(s) - medicine , cytopenia , polycythemia vera , hematocrit , hydroxycarbamide , gastroenterology , toxicity , polycythemia rubra vera , acute leukemia , hematology , leukemia , surgery , chemotherapy , bone marrow
Conventional treatment of polycythemia vera (PV) with radioactive phosphorus or alkylating agents is associated with a significant excess of acute leukemia and cancer of the gastrointestinal tract and skin. There is thus a need for a nonmutagenic agent in the treatment of this disorder. Hydroxyurea (HU) was administered to 118 patients with a loading dose of 30 mg/kg/day for 1 week, which was then reduced to 15 mg/kg/day. Initial control of the elevated hematocrit and platelet count was achieved within 12 weeks in over 80% of patients. Long‐term disease control was defined and the accumulative 1‐year failure‐free survival was 73% in the previously untreated patients and 59% in those patients previously treated with other myelosuppressive modalities. The HU was well tolerated and cytopenia, which generally occurred within the first 8 weeks of therapy, was transient and of little clinical significance. However, it is recommended because of this toxicity that HU be administered initially at a dose of 15‐20 mg/kg/day. Three patients developed acute leukemia; two were untreated and one had had myelosuppressive therapy. Hydroxyurea is an effective agent in the treatment of PV, but continued assessment of its mutagenic potential is necessary.