Korean J Hematol.  2008 Jun;43(2):83-88. 10.5045/kjh.2008.43.2.83.

The Efficacy and Adverse Effect of Hydroxyurea as Compared with Anagrelide in Essential Thrombocythemia

• Seol YM
• Kwon BR
• Choi YJ
• Lee KW
• Shin HJ
• Chung JS
• Lee EY
• Lee WS
• Joo YD
• Cho GJ

• KMID: 2252200
• DOI: http://doi.org/10.5045/kjh.2008.43.2.83

Abstract

BACKGROUND: Although the platelet count may not always correlate with the risk of thrombosis, there is evidence that a strict control of the platelet count decreases the incidence of thrombotic and hemorrhagic complications. However, it is difficult to select an appropriate platelet-lowering agent. This retrospective study was performed to assess the efficacy and adverse effect of the use of hydroxyurea and anagrelide for patients with essential thrombocythemia.
METHODS
Sixty patients with essential thrombocythemia received either hydroxyurea (n=30) or anagrelide (n=30). Early responses and adverse effects of hydroxyurea and anagrelide in the patients were retrospectively analyzed.
RESULTS
Treatment with anagrelide or hydroxyurea resulted in a rapid decrease of the platelet count within two weeks. The response rates after treatment with hydroxyurea and anagrelide were 83% and 77%, respectively. As compared with patients treated with hydroxyurea, patients treated with anagrelide presented with adverse effects such as headache palpitation was also frequently noticed (P=0.001). However, serious hemorrhage (n=2) and transformation to leukemia (n=1) occurred in patients treated with hydroxyurea.
CONCLUSION
Both anagrelide and hydroxyurea were effective and well-tolerated agents for the reduction of the platelet count. Long-term efficacy and adverse effects of the drugs remain to be determined.

Keyword

Essential thrombocythemia; Anagrelide; Hydroxyurea

MeSH Terms

Headache
Hemorrhage
Humans
Hydroxyurea
Incidence
Leukemia
Platelet Count
Quinazolines
Retrospective Studies
Thrombocythemia, Essential
Thrombosis
Hydroxyurea
Quinazolines

Figure

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  Fig. 1 Median of platelet count, according to weeks after treatment. Platelet counts were significantly different between two groups at two and four weeks. RR, response rate; W, week.

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  Fig. 2 Kaplan-Meier estimates of the event of thrombotic, hemorrhagic event and leukemic transformation.

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