[Treatment of polycythemia with 32P with or without hydroxyurea maintenance therapy. Preliminary results in 237 elderly and high vascular risk subjects studied since 1980].
Between 1980 and 1992, 237 polycythaemic patients aged 65 or more, or with high vascular risk factors were treated with 32P according to a protocol using, or not, maintenance therapy with low-dose hydroxy-urea (500 mg/day). The present follow-up covers 1448 years/patient. Maintenance therapy was seldom discontinued because of blood toxicity or gastrointestinal intolerance, but it was stopped in 20 percent of the cases because monitoring was difficult in very old patients. Maintenance therapy reduced the mean annual 32P dose by at least 50 percent. However, the actual risk of malignant blood diseases (myelodysplasia, acute leukaemia, lymphoma) was similar in the two arms of the protocol: 14 percent at the 10th year. Compared with the French population of the same age-groups, there was no excess of epithelial cancers in both arms. Maintenance therapy did not control platelet counts perfectly. The risk of severe vascular events was identical in both arms; probably no higher than expected at that age and significantly lower than in previously published data. The actuarial survival curves in both groups showed a 50 percent survival of about 11 years, i.e. very near to that of the reference French population (12.5 years) of similar sex and age.
Najean
Y
Y
Service de Médecine nucléaire, Hôpital Saint-Louis, Paris.
Rain
J D
JD
Toubert
M E
ME
D000367:Age Factors; D000368:Aged; D002277:Carcinoma / Q000209:etiology; D002318:Cardiovascular Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D006918:Hydroxyurea / Q000008:administration & dosage / Q000627:therapeutic use*; D007275:Injections, Intravenous; D015470:Leukemia, Myeloid, Acute / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000209:etiology; D010761:Phosphorus Radioisotopes / Q000008:administration & dosage / Q000627:therapeutic use*; D011086:Polycythemia / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D055728:Primary Myelofibrosis / Q000209:etiology; D012307:Risk Factors
D010761:Phosphorus Radioisotopes; D006918:Hydroxyurea
Traitement des polyglobulies par 32P avec ou sans traitement d'entretien par hydroxyurée. Résultats préliminaires chez 237 sujets âgés ou à haut risque vasculaire étudiés depuis 1980.