2005
DOI: 10.1182/blood-2004-09-3426
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Acute leukemia in polycythemia vera: an analysis of 1638 patients enrolled in a prospective observational study

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Cited by 388 publications
(362 citation statements)
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“…[69][70][71][72] By contrast, a leukemogenic potential of hydroxyurea (HU) has not been shown in clinical trials, although there is evidence showing that the sequential use of HU and other cytoreductive drugs (alkylating agents, radioactive phosphorus) increases the risk of AL/MDS. [72][73][74][75] In addition, several retrospective studies did not find an increased risk of AL in PV and ET treated with HU alone, [76][77][78] and similar conclusions were drawn from a recent meta-analysis of HU therapy in sickle cell anemia. 79 Still, very long-term results of prospective studies in HU-treated MPN patients with more than 10 years of follow-up showed a cumulative incidence of AL/MDS of more than 10% beyond 12 years of follow-up, suggesting that the risk of leukemic evolution could be higher than reported earlier in studies with shorter follow-up.…”
Section: Ifn-a and Leukemic Evolutionsupporting
confidence: 55%
“…[69][70][71][72] By contrast, a leukemogenic potential of hydroxyurea (HU) has not been shown in clinical trials, although there is evidence showing that the sequential use of HU and other cytoreductive drugs (alkylating agents, radioactive phosphorus) increases the risk of AL/MDS. [72][73][74][75] In addition, several retrospective studies did not find an increased risk of AL in PV and ET treated with HU alone, [76][77][78] and similar conclusions were drawn from a recent meta-analysis of HU therapy in sickle cell anemia. 79 Still, very long-term results of prospective studies in HU-treated MPN patients with more than 10 years of follow-up showed a cumulative incidence of AL/MDS of more than 10% beyond 12 years of follow-up, suggesting that the risk of leukemic evolution could be higher than reported earlier in studies with shorter follow-up.…”
Section: Ifn-a and Leukemic Evolutionsupporting
confidence: 55%
“…There are, to date, no controlled studies that implicate either hydroxyurea or busulfan as being leukemogenic in either ET or PV. Similarly, the two largest non-controlled studies in ET [54] and PV [108] do not support the concern that leukemia might arise from the use of hydroxyurea and there is additional evidence to that effect from long-term studies of patients receiving hydroxyurea for sickle cell disease [123]. The evidence for busulfan leukemogenicity in the context of treatment for PV or ET is equally weak and inappropriately extrapolated from older patients with advanced phase disease and exposed to multiple cytoreductive drugs.…”
Section: Annual Clinical Updates In Hematological Malignanciesmentioning
confidence: 99%
“…Similarly, the incidence of AML in patients treated with hydroxyurea, compared to a historical control treated with either chlorambucil or radiophosphorus, was significantly lower (5.9 % vs. 10.6% vs. 8.3%, respectively, in the first 11 years of treatment) [105]. Other studies have confirmed the low incidence of AML in PV patients treated with hydroxyurea (1-5.6%) [106][107][108].…”
Section: Annual Clinical Updates In Hematological Malignanciesmentioning
confidence: 99%
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“…Thrombotic complications are the main cause of morbidity and mortality, occurring in more than one third of patients and causing 35-45% of deaths [5,6]. Other possible adverse events are the evolution into secondary myelofibrosis (MF) or acute myeloid leukemia (AML) occurring in 10-15% [4,[6][7][8] and 2-15% [4,[8][9][10][11][12][13][14][15][16] of patients, respectively, depending on treatments and with increased incidence with long-standing disease.…”
Section: Introductionmentioning
confidence: 99%