Polycythemia vera and hydroxyurea resistance/intolerance: a monocentric retrospective analysis

被引:19
作者
Demuynck, T. [1 ]
Verhoef, G. [2 ]
Delforge, M. [2 ]
Vandenberghe, P. [2 ,3 ]
Devos, Timothy [2 ,4 ]
机构
[1] Univ Hosp Leuven, Dept Internal Med, Leuven, Belgium
[2] Univ Hosp Leuven, Dept Hematol, Herestr 49, B-3000 Leuven, Belgium
[3] Katholieke Univ Leuven, Dept Human Genet, Leuven, Belgium
[4] Katholieke Univ Leuven, Dept Microbiol & Immunol, Lab Expt Transplantat, Leuven, Belgium
关键词
Polycythemia vera; Hydroxyurea resistance; intolerance; Ruxolitinib; European leukemia net criteria; QUALITY-OF-LIFE; PROGNOSTIC VALUE; RUXOLITINIB; HYDROXYCARBAMIDE; MYELOFIBROSIS; INTOLERANCE; MANAGEMENT; RESISTANCE; NEOPLASMS; THERAPY;
D O I
10.1007/s00277-019-03654-6
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Hydroxyurea (HU) resistance or intolerance occurs in 15 to 24% of patients with polycythemia vera (PV). Resistance to HU is associated with a shortened life expectancy, intolerance has no prognostic value. We assessed the occurrence of HU resistance or intolerance comparing the original (ELNo) versus the modified European Leukemia Net (ELNm) criteria as applied in recent large clinical trials including PV patients. We retrospectively analyzed 106 patients with PV treated with HU at the University Hospitals of Leuven between 1990 and 2016 for occurrence of HU resistance/intolerance when using both ELNo as ELNm. After a mean duration of treatment of 5.1years, when applying the ELNo 20.7% of patients had shown resistance or intolerance to HU in comparison to 39.6% when using the ELNm. When using the ELNo 4.7% of patients were resistant to HU versus 23.6% when applying the ELNm. In total, 16.0% of patients were HU intolerant. This rate was identical when using both ELNo and ELNm. 20.7% of PV patients were considered as HU-resistant or intolerant when using the original ELN criteria. However, when applying the modified ELN criteria 39.6% of PV patients were resistant or intolerant to HU. In our hands, no patient received a minimum dose of 2g HU a day, as such the ELNm seem better adapted for daily clinical use. However, the prognostic value of HU-resistance in PV, when defined by the ELNm, still needs to be confirmed.
引用
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页码:1421 / 1426
页数:6
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