Comparison of platelet count reduction in patients with essential thrombocythaemia treated with hydroxyurea and thromboreductin. Single centre experience (RCD code: VIII)

Anna Prochwicz, Szymon Fornagiel, Katarzyna Krawczyk, Dorota Krochmalczyk

Full Text:

PDF

Abstract


Essential thrombocythemia is one of the Ph-negative myeloproliferative neoplasms treated with hydroxyurea. An alternative strategy may be a therapy with thromboreductin. The aim of the study was to compare the effectiveness of hydroxyurea and thromboreductin treatment, defined by a decrease in the platelet count. The study group consisted of 154 patients with essential thrombocythemia diag‐
nosed and treated at the Outpatient Clinic of Hematology in Krakow, Poland between 1995 and 2016. Patients were included in the study at the start of cytoreductive treatment. 102 patients was treated with hydroxyurea and 52 patients treated with thromboreducin. We set  the limit values for the number of platelets on levels : <800 x 10 9 /L, <600 x 10 9 /L, <450 x 10 9 /L and <350 x 10 9 /L. Afterwards, the analysis of the time required to achieve each point was performed. A comparison of hydroxyurea and thromboreductin groups showed that the number of platelets at the beginning of therapy was significantly lower in patients treated with hydroxyurea. Platelets value in the last control was significantly lower in patients treated with thromboreductin than hydroxyurea. The change in total platelet count over the time was significantly higher in the thromboreductin group. Patients treated with thromboreductin had a faster platelets reduction lower than 450 x10 9 /L. Tromboreductin is effective in reducing the number of platelets in patients with resistant essential thrombocythemia or intolerant of hydroxyurea regardless of age. JRCD 2018; 3 (8): 266–270


Keywords


essential thrombocythaemia; thromboreductin; hydroxyurea; platelets reduction

References


Arber DA, Orazi A, Hasserjian R, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood 2016; 127: 2391–2405.

Srour SA, Devesa SS, Morton LM, et al. Incidence and patient survival of myeloproliferative neoplasms and myelodysplastic/myeloproliferative neoplasms in the United States, 2001–12. Br J Haematol 2016; 174: 382–396.

Girodon F, Bonicelli G, Schaeffer C, et al. Significant increase in the apparent incidence of essential thrombocythemia related to new WHO diagnostic criteria: a population‐based study. Haematologica 2009; 94: 865–869.

Vainchenker W, Kralovics R. Genetic basis and molecular pathophysiology of classical myeloproliferative neoplasms. Blood 2017; 129: 667–679.

Kittur J, Knudson RA, Lasho TL, et al. Clinical correlates of JAK2V617F allele burden in essential thrombocythemia. Cancer 2007; 109: 2279–2284.

Rotunno G, Mannarelli C, Guglielmelli P, et al. Impact of calreticulin mutations on clinical and hematological phenotype and outcome in essential thrombocythemia. Blood 2014; 123: 1552–1555.

Beer PA, Campbell PJ, Scott LM, et al. MPL mutations in myeloproliferative disorders: analysis of the PT‐1 cohort. Blood 2008; 112: 141–149.

Kleman A, Singavi AK, Michaelis LC. Current challenges in the management of essential thrombocythemia. Clin Adv Hematol Oncol 2017;15: 773–783.

Tefferi A, Vannucchi AM, Barbui T. Essential thrombocythemia treatment algorithm 2018. Blood Cancer J 2018; 8: 1–2.

Barbui T, Barosi G, Birgegard G, et al. European LeukemiaNet. Philadelphia‐negative classical myeloproliferative neoplasms: critical concepts and management recommendations from European LeukemiaNet. J Clin Oncol 2011; 29: 761–770.

Yarbro JW. Mechanism of action of hydroxyurea. Semin Oncol 1992; 19 (3 Suppl 9): 1–10.

Carobbio A, Finazzi G, Antonioli E, et al. Hydroxyurea in essential thrombocythemia: rate and clinical relevance of responses by European LeukemiaNet criteria. Blood 2010; 116: 1051–1055.

Antonioli E, Guglielmelli P, Pieri L, et al. Hydroxyurea‐related toxicity in 3,411 patients with Ph’-negative MPN. Am J Hematol 2012; 87: 552–554.

Harrison CN, Campbell PJ, Buck G, et al. Hydroxyurea compared with anagrelide in high‐risk essential thrombocythemia. N Engl J Med 2005; 353: 33–45.

Barosi G, Besses C, Birgegard G, et al. A unified definition of clinical resistance/intolerance to hydroxyurea in essential thrombocythemia: results of a consensus process by an international working group. Leukemia 2007; 21: 277–280.

Espasandin YR, Glembotsky AC, Grodzielski M, et al. Anagrelide platelet‐lowering effect is due to inhibition of both megakaryocyte maturation and proplatelet formation: insight into potential mechanisms. J Thromb Haemost 2015; 13: 631–642.

Birgegård G, Björkholm M, Kutti J, et al. Adverse effects and benefits of two years of anagrelide treatment for thrombocythemia in chronic myeloprolif‐ erative disorders. Haematologica 2004; 89: 520–527.

Besses C, Alvarez‐Larrán A, Gómez M, et al. Clinical Evaluation of the European LeukemiaNet Criteria for Resistance/Intolerance to Hydroxyurea In Essential Thrombocythemia. Blood 2010; 116: 4086.

Bazzan M, Tamponi G, Schinco P, et al. Thrombosis‐free survival and life expectancy in 187 consecutive patients with essential thrombocythemia. Ann Hematol 1999; 78: 539–543.

Wolanskyj AP, Schwager SM, McClure RF, et al. Essential thrombocythemia beyond the first decade: life expectancy, long‐term complication rates, and prognostic factors. Mayo Clin Proc 2006; 81: 159–166.

Campbell PJ, Maclean C, Beer PA, et al. Correlation of blood counts with vascular complications in essential thrombocythemia: analysis of the prospective PT1 cohort. Blood. 2012; 120: 1409–1411.

Barbui T, Barosi G, Birgegard G, et al. Philadelphia‐negative classical myelo proliferative neoplasms: critical concepts and management recommendations from European LeukemiaNet. J Clin Oncol 2011; 29: 761–770.

Finazzi G, Carobbio A, Thiele J, et al. Incidence and risk factors for bleeding in 1104 patients with essential thrombocythemia or prefibrotic myelofibrosis diagnosed according to the 2008 WHO criteria. Leukemia 2012; 26: 716–719.

Mital A, Prejzner W, Bieniaszewska M, et al. Prevalence of acquired von Willebrand syndrome during essential thrombocythemia: a retrospective analysis of 170 consecutive patients. Pol Arch Med Wewn 2015; 125:914–920.

Steurer M, Gastl G, Jedrzejczak WW, et al. Anagrelide for thrombocytosis in myeloproliferative disorders: a prospective study to assess efficacy and adse of Anagrelide in Myeloproliferative Neoplasms, with Focus on Essential Thrombocythemia. Curr Hematol Malig Rep3 patients in the EXELS study. Leuk Res 2013; 37: 162–168.

Gugliotta L, Tieghi A, Tortorella G, et al. Low impact of cardiovascular adverse events on anagrelide treatment discontinuation in a cohort of 232 patients with essential thrombocythemia. Leuk Res 2011; 35: 1557–1563.

Besses C, Kiladjian JJ, Griesshammer M, et al. Cytoreductive treatment patterns for essential thrombocythemia in Europe. Analysis of 3643 patients in the EXELS study. Leuk Res 2013; 37: 162–168.

Birgegård G. The Use of Anagrelide in Myeloproliferative Neoplasms, with Focus on Essential Thrombocythemia. Curr Hematol Malig R. Besses C, Kiladjian JJ, Griesshammer M, et al. Cytoreductive treatment patterns for essential thrombocythemia in Europe. Analysis of 3643 patients in the EXELS study. Leuk Res 2013; 37: 162–168.

Tortorella G, Calzolari M, Tieghi A, et al. Acute coronary syndrome (ACS) in patients with essential thrombocytemia (ET). What is the best treatment? Int J Cardiol 2016; 203: 225–227.ep 2016; 11: 348–355.




DOI: http://dx.doi.org/10.20418%2Fjrcd.vol3no8.362

Refbacks

  • There are currently no refbacks.
Journal of Rare Cardiovascular Diseases (JRCD)
John Paul II Hospital in Kraków, 80 Prądnicka Str., 31-202 Kraków, Poland
Phone: +48 (12) 614 33 99, +48 (12) 614 34 88 Fax: +48 (12) 614 34 88
e-mail: rarediseases@szpitaljp2.krakow.pl
Published by SoftQ sp. z o.o.
ul. Oleandry 2, 30-063 Kraków, Poland
Phone: +48 (12) 444 1650 Fax: +48 (12) 444 1659
e-mail: softq@softq.pl