title: Successful long-term treatment of Philadelphia chromosome-negative myeloproliferative neoplasms with combination of hydroxyurea and anagrelide.
abstract: BACKGROUND
  Resistance or intolerance to either of the 2 favored therapeutic choices for MPN is a common clinical challenge. To overcome this, we report our successful long-term experience with the combination of low-dose HU and AG.
  
  
  METHODS
  Retrospective review identified 12 patients with essential thrombocythemia or polycythemia vera using combination therapy.
  
  
  RESULTS
  The mean duration of treatment 4.25 years. Combination therapy achieved a 45% median platelet count reduction with relatively low daily dose requirements (711 mg HU, 1.38 mg AG). All but 1 patient achieved partial (25%) or complete response (67%) according to European LeukemiaNet criteria. No arterial or venous thrombosis, or bleeding events occurred.
  
  
  CONCLUSIONS
  This is the longest follow-up experience of an HU and AG combination regimen in MPN. The low-dose combination regimen effectively achieved clinical and laboratory response while simultaneously minimizing dose-related adverse reactions, and should be the preferred therapeutic alternative to third-line agents in MPN patients who are resistant or intolerant to monotherapy.
authors.affiliation: Department of Medicine, The Methodist Hospital, Houston, TX.
authors.forename: Inhye E
authors.initials: IE
authors.lastname: Ahn
authors.forename: Ethan
authors.initials: E
authors.lastname: Natelson
authors.forename: Lawrence
authors.initials: L
authors.lastname: Rice
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006918:Hydroxyurea / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009196:Myeloproliferative Disorders / Q000188:drug therapy* / Q000235:genetics*; D010677:Philadelphia Chromosome; D011087:Polycythemia Vera / Q000188:drug therapy / Q000235:genetics; D011799:Quinazolines / Q000008:administration & dosage; D012189:Retrospective Studies; D013920:Thrombocythemia, Essential / Q000188:drug therapy / Q000235:genetics; D013927:Thrombosis / Q000188:drug therapy / Q000235:genetics
chemical_list: D011799:Quinazolines; C021139:anagrelide; D006918:Hydroxyurea
keywords: Anagrelide; Essential thrombocythemia; Hydroxyurea; Polycythemia vera; Thrombosis