Risk of thrombosis according to need of phlebotomies in patients with polycythemia vera treated with hydroxyurea.

Mostra el registre complet Registre parcial de l'ítem

• dc.contributor.author Álvarez Larrán, Albertoca
• dc.contributor.author Cruz, Yasminaca
• dc.contributor.author Montesdeoca, Saraca
• dc.contributor.author García-Pallarols, Francescca
• dc.contributor.author Besses Raebel, Carlesca
• dc.contributor.author Grupo Español de Neoplasias Mieloproliferativas Filadelfia Negativasca
• dc.date.accessioned 2017-01-20T11:22:24Z
• dc.date.available 2017-01-20T11:22:24Z
• dc.date.issued 2017
• dc.description.abstract Hematocrit control below 45% is associated with a lower rate of thrombosis in polycythemia vera. In patients receiving hydroxyurea, this target can be achieved with hydroxyurea alone or with the combination of hydroxyurea plus phlebotomies. However, the clinical implications of phlebotomy requirement under hydroxyurea therapy are unknown. The aim of this study was to evaluate the need for additional phlebotomies during the first five years of hydroxyurea therapy in 533 patients with polycythemia vera. Patients requiring 3 or more phlebotomies per year (n=85, 16%) showed a worse hematocrit control than those requiring 2 or less phlebotomies per year (n=448, 84%). There were no significant differences between the two study groups regarding leukocyte and platelet counts. Patients requiring 3 or more phlebotomies per year received significantly higher doses of hydroxyurea than the remaining patients. A significant higher rate of thrombosis was found in patients treated with hydroxyurea plus 3 or more phlebotomies per year compared to hydroxyurea with 0-2 phlebotomies per year (20.5% vs. 5.3% at 3 years; P<0.0001). In multivariate analysis, independent risk factors for thrombosis were phlebotomy dependency (HR: 3.3, 95%CI: 1.5-6.9; P=0.002) and thrombosis at diagnosis (HR: 4.7, 95%CI: 2.3-9.8; P<0.0001). The proportion of patients fulfilling the European LeukemiaNet criteria of resistance/intolerance to hydroxyurea was significantly higher in the group requiring 3 or more phlebotomies per year (18.7% vs. 7.1%; P=0.001) mainly due to extrahematologic toxicity. In conclusion, phlebotomy requirement under hydroxyurea therapy identifies a subset of patients with increased proliferation of polycythemia vera and higher risk of thrombosis.ca
• dc.description.sponsorship This work was supported by a grant from the Instituto de Salud Carlos III, Spanish Health Ministry, PI13/00557, PI1300393. The GEMFIN received a grant from Novartis for the development of the Spanish Registry of Polycythemia Vera and for conducting the present project.
• dc.format.mimetype application/pdfca
• dc.identifier.citation Alvarez-Larrán A, Pérez-Encinas M, Ferrer-Marín F, Hernández-Boluda JC, Ramírez MJ, Martínez-López J. et al. Risk of thrombosis according to need of phlebotomies in patients with polycythemia vera treated with hydroxyurea. Haematologica. 2017 Jan;102(1):103-109. doi: 10.3324/haematol.2016.152769ca
• dc.identifier.doi http://dx.doi.org/10.3324/haematol.2016.152769
• dc.identifier.issn 0390-6078
• dc.identifier.uri http://hdl.handle.net/10230/27941
• dc.language.iso engca
• dc.publisher Ferrata Storti Foundationca
• dc.relation.ispartof Haematologica. 2017 Jan;102(1):103-9
• dc.rights Copyright © Ferrata Storti Foundation. http://dx.doi.org/10.3324/haematol.2016.152769ca
• dc.rights.accessRights info:eu-repo/semantics/openAccessca
• dc.subject.other Trombosica
• dc.subject.other Policitèmia veraca
• dc.title Risk of thrombosis according to need of phlebotomies in patients with polycythemia vera treated with hydroxyurea.ca
• dc.type info:eu-repo/semantics/articleca
• dc.type.version info:eu-repo/semantics/acceptedVersionca