Treatment Patterns and Blood Counts in Patients With Polycythemia Vera Treated With Hydroxyurea in the United States: An Analysis From the REVEAL Study.

Autor: Grunwald MR; Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC. Electronic address: michael.grunwald@atriumhealth.org., Kuter DJ; Center for Hematology, Massachusetts General Hospital, Boston, MA., Altomare I; Duke Cancer Network, Duke University Medical Center, Durham, NC., Burke JM; US Oncology Hematology Research Program, Rocky Mountain Cancer Centers, Aurora, CO., Gerds AT; Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH., Walshauser MA; Department of Medical Oncology and Hematology, Cancer Care Specialists of Illinois, Swansea, IL., Savona MR; Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN., Stein B; Department of Hematology and Oncology, Northwestern University, Chicago, IL., Oh ST; Department of Medicine, Washington University School of Medicine, St. Louis, MO., Colucci P; Incyte Corporation, Wilmington, DE., Parasuraman S; Incyte Corporation, Wilmington, DE., Paranagama D; Incyte Corporation, Wilmington, DE., Mesa R; Department of Hematology and Oncology, The University of Texas Health Science Center, San Antonio, TX.
Jazyk: angličtina
Zdroj: Clinical lymphoma, myeloma & leukemia [Clin Lymphoma Myeloma Leuk] 2020 Apr; Vol. 20 (4), pp. 219-225. Date of Electronic Publication: 2019 Sep 30.
DOI: 10.1016/j.clml.2019.09.601
Abstrakt: Background: Polycythemia vera (PV) is associated with increased blood cell counts, risk of thrombosis, and symptoms including fatigue and pruritus. National guidelines support the use of hydroxyurea (HU) in high-risk patients or those with some other clinical indication for cytoreduction.
Patients and Methods: REVEAL is a prospective, observational study designed to collect data pertaining to demographics, disease burden, clinical management, patient-reported outcomes, and health care resource utilization of patients with PV in the United States. In this analysis, HU treatment patterns and outcomes were assessed from 6 months prior to enrollment to the time of discontinuation, death, or data cutoff.
Results: Of the 1381 patients who received HU for ≥ 3 months, the median HU exposure was 23.6 months (range, 3.1-38.5 months). The most common maximum daily HU doses were 1000 mg (30.6%) and 500 mg (30.1%); only 6.4% received ≥ 2 g/d HU. Approximately one-third (32.3%) of patients had dose adjustments, 23.8% had dose interruptions, and 257 (18.6%) discontinued HU. The most common reasons for HU discontinuations and interruptions were adverse events/intolerance (37.1% and 54.5%, respectively) and lack of efficacy (35.5% and 22.1%, respectively). Of those who received HU for ≥ 3 months, 57.1% had hematocrit values > 45% on ≥ 1 occasion, 33.1% continued to receive phlebotomies, and 27.4% had uncontrolled myeloproliferation.
Conclusion: The results of this analysis emphasize the need for active management of patients with PV with appropriate HU dose titration to maintain blood count control while monitoring for signs and symptoms of HU intolerance.
(Copyright © 2019 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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