Anagrelide treatment in 52 patients with chronic myeloproliferative diseases.
In this retrospective multi-centre study, we report our experience with anagrelide in the treatment of thrombocytosis in patients with chronic myeloproliferative diseases. Our study included 52 patients (age 20-78 years). The initial anagrelide dose was, in general, 0.5 mg once daily and mean maintenance dosage was 1.7 mg/day. The overall response rate was 79% including 75% complete remission and 4% partial remission. Forty-two patients (81%) had adverse effects and in 29% of the study population, the adverse effects necessitated cessation of anagrelide. The most common adverse effect was moderate anaemia (50%). Two patients experienced erectile dysfunction which has been described only once previously in association with anagrelide treatment. One patient progressed to acute leukaemia. However, this patient had been pre-treated with two potentially leukaemogenic drugs and had only been in short-term treatment with anagrelide. Furthermore, a total of 13 events were recorded. More than 25% of these events occurred in patients with platelet counts between 400 and 600 x 10(9)/l and almost 40% of all events occurred in patients with platelet counts above 400 x 10(9)/l. This observation supports the hypothesis that aggressive control of thrombocytosis to a platelet count <400 x 10(9)/l might reduce the number of thrombohaemorrhagic events. Anagrelide is safe and effective in reducing the platelet counts, but a high proportion of the patients discontinue treatment because of the adverse effects of the drug.
Department of Haematology, National University Hospital, Rigshospitalet, Copenhagen, Denmark.
E
E
Penninga
B A
BA
Jensen
P B
PB
Hansen
N T
NT
Clausen
T
T
Mourits-Andersen
O J
OJ
Nielsen
H C
HC
Hasselbalch
D000328:Adult; D000368:Aged; D000740:Anemia / Q000139:chemically induced; D002908:Chronic Disease; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D009196:Myeloproliferative Disorders / Q000150:complications / Q000188:drug therapy*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use / Q000633:toxicity; D011799:Quinazolines / Q000008:administration & dosage / Q000627:therapeutic use* / Q000633:toxicity; D012189:Retrospective Studies; D013922:Thrombocytosis / Q000188:drug therapy; D013923:Thromboembolism / Q000139:chemically induced; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors; D011799:Quinazolines; C021139:anagrelide