%0 Journal Article
%A Alvarez-Larrán, Alberto
%A Kerguelen, Ana
%A Hernández-Boluda, Juan C
%A Pérez-Encinas, Manuel
%A Ferrer-Marín, Francisca
%A Bárez, Abelardo
%A Martínez-López, Joaquín
%A Cuevas, Beatriz
%A Mata, M Isabel
%A García-Gutiérrez, Valentín
%A Aragües, Pilar
%A Montesdeoca, Sara
%A Burgaleta, Carmen
%A Caballero, Gonzalo
%A Hernández-Rivas, J Angel
%A Durán, M Antonia
%A Gómez-Casares, M Teresa
%A Besses, Carles
%A Grupo Español de Enfermedades Mieloproliferativas Filadelfia Negativas (GEMFIN)
%T Frequency and prognostic value of resistance/intolerance to hydroxycarbamide in 890 patients with polycythaemia vera.
%D 2015
%U https://hdl.handle.net/10668/26696
%X The clinical significance of resistance/intolerance to hydroxycarbamide (HC) was assessed in a series of 890 patients with polycythaemia vera (PV). Resistance/intolerance to HC was recorded in 137 patients (15·4%), consisting of: need for phlebotomies (3·3%), uncontrolled myeloproliferation (1·6%), failure to reduce massive splenomegaly (0·8%), development of cytopenia at the lowest dose of HC to achieve a response (1·7%) and extra-haematological toxicity (9%). With a median follow-up of 4·6 years, 99 patients died, resulting in a median survival of 19 years. Fulfilling any of the resistance/intolerance criteria had no impact on survival but when the different criteria were individually assessed, an increased risk of death was observed in patients developing cytopenia [Hazard ratio (HR): 3·5, 95% confidence interval (CI): 1·5-8·3, P = 0·003]. Resistance/intolerance had no impact in the rate of thrombosis or bleeding. Risk of myelofibrotic transformation was significantly higher in those patients developing cytopenia (HR: 5·1, 95% CI: 1·9-13·7, P = 0·001) and massive splenomegaly (HR: 9·1, 95% CI: 2·3-35·9, P = 0·002). Cytopenia at the lowest dose required to achieve a response was also an independent risk factor for transformation to acute leukaemia (HR: 20·3, 95% CI: 5·4-76·5, P
%K hydroxycarbamide
%K myeloproliferative neoplasms
%K polycythaemia vera
%K resistance/intolerance
%K response criteria
%~