RT Journal Article
T1 Frequency and prognostic value of resistance/intolerance to hydroxycarbamide in 890 patients with polycythaemia vera.
A1 Alvarez-Larrán, Alberto
A1 Kerguelen, Ana
A1 Hernández-Boluda, Juan C
A1 Pérez-Encinas, Manuel
A1 Ferrer-Marín, Francisca
A1 Bárez, Abelardo
A1 Martínez-López, Joaquín
A1 Cuevas, Beatriz
A1 Mata, M Isabel
A1 García-Gutiérrez, Valentín
A1 Aragües, Pilar
A1 Montesdeoca, Sara
A1 Burgaleta, Carmen
A1 Caballero, Gonzalo
A1 Hernández-Rivas, J Angel
A1 Durán, M Antonia
A1 Gómez-Casares, M Teresa
A1 Besses, Carles
A1 Grupo Español de Enfermedades Mieloproliferativas Filadelfia Negativas (GEMFIN), 
K1 hydroxycarbamide
K1 myeloproliferative neoplasms
K1 polycythaemia vera
K1 resistance/intolerance
K1 response criteria
AB 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
YR 2015
FD 2015-12-21
LK https://hdl.handle.net/10668/26696
UL https://hdl.handle.net/10668/26696
LA en
DS RISalud
RD Apr 6, 2025