Premium
Symptomatic mucocutaneous toxicity of hydroxyurea in Philadelphia chromosome‐negative myeloproliferative neoplasms
Author(s) -
Latagliata Roberto,
Spadea Antonio,
Cedrone Michele,
Di Giandomenico Jonny,
De Muro Marianna,
Villivà Nicoletta,
Breccia Massimo,
Anaclerico Barbara,
Porrini Raffaele,
Spirito Francesca,
Rago Angela,
Avvisati Giuseppe,
Alimena Giuliana,
Montanaro Marco,
Andriani Alessandro
Publication year - 2011
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.26194
Subject(s) - medicine , mucocutaneous zone , discontinuation , toxicity , surgery , erythema , hyperpigmentation , gastroenterology , dermatology , disease
BACKGROUND: The current study was conducted to evaluate severe mucocutaneous toxicity during treatment with hydroxyurea (HU) in a large cohort of patients with Philadelphia chromosome‐negative myeloproliferative neoplasms (MPN). METHODS: Among 993 consecutive patients newly diagnosed with MPN at 4 centers in Rome between January 1980 and December 2009, 614 patients (277 men and 337 women with a median age of 64.4 years [interquartile range (IR), 54.4 years‐72.7 years]) received HU. HU was administered as first‐line treatment in 523 patients (85.2%) and as ≥ second‐line treatment in 91 patients (14.8%). RESULTS: Mucocutaneous toxicity was reported in 51 patients (8.3%) after a median period from the initiation of HU treatment of 32.1 months (IR, 10.5 months‐74.6 months) and a mean HU dose of 1085 mg (± 390 mg); 30 patients (58.8%) developed a painful ulcerative skin toxicity, mainly located in the perimalleolar area; 11 patients (21.6%) had oral aphthous ulcers; and 10 patients (19.6%) developed a nonulcerative skin toxicity with erythema and skin infiltration. After the mucocutaneous toxicity occurred, HU treatment was continued at the same dose in 5 patients (9.8%), reduced in 12 patients (23.5%), and temporarily discontinued in 7 patients (13.7%); the remaining 27 patients (52.9%) required a permanent drug discontinuation. After a median period of 4.3 months (IR, 2.4 months‐9.0 months) from the onset of the skin toxicity, 39 patients (76.5%) had a complete resolution and 12 patients (23.5%) had improvement without complete resolution. CONCLUSIONS: Mucocutaneous toxicity during HU treatment is more common than expected and may present with different clinical features. Moreover, it often requires a permanent drug discontinuation and only a partial resolution is reported to occur in approximately 25% of patients. Cancer 2011;. © 2011 American Cancer Society.