Literature DB >> 15476273

Anagrelide for thrombocytosis in myeloproliferative disorders: a prospective study to assess efficacy and adverse event profile.

Michael Steurer1, Guenther Gastl, Wieslaw-Wiktor Jedrzejczak, Robert Pytlik, Werner Lin, Ernst Schlögl, Heinz Gisslinger.   

Abstract

BACKGROUND: Although the platelet count does not correlate with the rate of thrombosis, there is evidence that a strict control of the platelet count decreases the incidence of thromboembolic complications in essential thrombocythemia. In the current study, the authors evaluated the efficacy and tolerability of anagrelide in thrombocytosis associated with myeloproliferative disorders.
METHODS: The study cohort comprised 97 patients (n = 69 females, n = 28 males) with a median age of 59 years (range, 21-80 years). Patients with essential thrombocythemia (n = 79) or with thrombocytosis due to polycythemia vera (n = 16) or to chronic idiopathic myelofibrosis (n = 2) were enrolled in the multicenter, prospective study. Patients received anagrelide at a starting dose of 0.5 mg twice per day, which was then adjusted for each patient.
RESULTS: Treatment with anagrelide resulted in a rapid decrease in the platelet count, from a median baseline platelet count of 743 x 10(9)/L to a median platelet count of 441 x 10(9)/L after 6 months (P < 0.0001). The proportion of patients with a platelet count < 600 x 10(9)/L increased from 30% at baseline to 77% after the 6-month study period. The rate of major thrombotic complications significantly decreased from 5% to 2% (P = 0.2568). For patients with essential thrombocythemia, the reduction of major thromboembolic complications was significant (P = 0.0455). The rate of minor thromboembolic complications decreased from 25% before anagrelide treatment to 14% during anagrelide treatment (P = 0.0278). No severe side effects were observed during the study period. There was, however, evidence that concomitant administration of acetylsalicylic acid may increase bleeding tendency.
CONCLUSIONS: Anagrelide was an effective and well tolerated treatment modality for reducing platelet counts in both newly diagnosed and pretreated patients with thrombocytosis due to myeloproliferative disorders. (c) 2004 American Cancer Society

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Year:  2004        PMID: 15476273     DOI: 10.1002/cncr.20646

Source DB:  PubMed          Journal:  Cancer        ISSN: 0008-543X            Impact factor:   6.860


  19 in total

Review 1.  Anagrelide: a review of its use in the management of essential thrombocythaemia.

Authors:  Antona J Wagstaff; Gillian M Keating
Journal:  Drugs       Date:  2006       Impact factor: 9.546

2.  Stress cardiomyopathy complicated by left ventricular thrombi and cerebral infarctions in a patient with essential thrombocythemia.

Authors:  Seung Hwan Hwang; Kye Hun Kim; Hyun Ju Yoon; Young Joon Hong; Ju Han Kim; Young Keun Ahn; Myung Ho Jeong; Jeong Gwan Cho; Jong Chun Park; Jung Chaee Kang
Journal:  J Cardiovasc Ultrasound       Date:  2011-06-30

3.  Limitations of fibrosis grade as diagnostic criteria for post polycythemia vera and essential thrombocytosis myelofibrosis.

Authors:  K Gowin; S Verstovsek; N Daver; N Pemmaraju; R Valdez; H Kosiorek; A Dueck; R Mesa
Journal:  Leuk Res       Date:  2015-04-17       Impact factor: 3.156

Review 4.  Advances and challenges in the management of essential thrombocythemia.

Authors:  Gunnar Birgegård
Journal:  Ther Adv Hematol       Date:  2015-06

Review 5.  Polycythaemia vera and essential thrombocythaemia: current treatment strategies.

Authors:  Elisabeth I Penninga; Ole W Bjerrum
Journal:  Drugs       Date:  2006       Impact factor: 9.546

6.  Development of acute myocardial infarction in a young female patient with essential thrombocythemia treated with anagrelide: a case report.

Authors:  Young-Hyo Lim; Young Yiul Lee; Jae Hoon Kim; Jinho Shin; Jae Ung Lee; Kyung-Soo Kim; Soon-Kil Kim; Jeong Hyun Kim; Heon Kil Lim
Journal:  Korean J Hematol       Date:  2010-06-30

7.  Anagrelide compared with hydroxyurea in WHO-classified essential thrombocythemia: the ANAHYDRET Study, a randomized controlled trial.

Authors:  Heinz Gisslinger; Mirjana Gotic; Jerzy Holowiecki; Miroslav Penka; Juergen Thiele; Hans-Michael Kvasnicka; Robert Kralovics; Petro E Petrides
Journal:  Blood       Date:  2013-01-11       Impact factor: 22.113

8.  Open-label, dose-titration and continuation study to assess efficacy, safety, and pharmacokinetics of anagrelide in treatment-naïve Japanese patients with essential thrombocythemia.

Authors:  Shinichiro Okamoto; Yoshitaka Miyakawa; Jonathan Smith; Ian Hodgson; Brihad Abhyankar; Steven Troy; Yuzuru Kanakura
Journal:  Int J Hematol       Date:  2013-02-03       Impact factor: 2.490

Review 9.  Headache in essential thrombocythaemia.

Authors:  R Frewin; A Dowson
Journal:  Int J Clin Pract       Date:  2012-08-14       Impact factor: 2.503

10.  Ruxolitinib for myelofibrosis.

Authors:  Lian Gu; Li Su; Qing Chen; Juanjuan Xie; Guangliang Wu; Yan Yan; Baoyun Liang; Jinjing Tan; Nong Tang
Journal:  Exp Ther Med       Date:  2013-01-07       Impact factor: 2.447

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