From our friends at MPN Hub. A very Interesting and easy to understand review of a recent article. Some excerpts are copied below. It is worth reading the whole article to understand the findings.
mpn-hub.com/medical-informa...
Currently, hydroxyurea (HU) is the most used cytoreductive therapy, but it is associated with poor responses and toxicity in a significant proportion of patients. Moreover, the predictors of a complete response (CR) with HU and its prognostic implications are yet to be defined.1 The impact of different types of suboptimal responses in patients switching to ruxolitinib (RUX) is also unclear.1 ....
Clinical outcomes based on response to HU
Among the 449 patients receiving only HU, 51 thrombotic events, 25 hemorrhagic events, and 43 infections were recorded.
52 patients developed a secondary primary malignancy, 14 patients progressed to post-PV myelofibrosis, 10 progressed to blast phase, and death was reported in 35 patients.
Achieving a response defined by European LeukemiaNet with HU was not associated with a reduced risk of thrombosis (p = 0.86), decreased risk of disease progression (p = 0.9), or reduced risk of death (p = 0.86).
However, prior thrombotic events were associated with subsequent thrombotic events (p = 0.01).
An age of ≥65 years was associated with an increased mortality risk (p = 0.02).
Conclusion
This real-world, retrospective cohort study highlights the importance of optimizing HU dosing. Although higher HU dosing achieves greater rates of CR it also increases the risk of TRAEs. In addition, the study also demonstrates the lack of an association between CR and reduced thrombotic risk. Therefore, HU dosing should be determined based on individual patient needs. Furthermore, a large proportion of stable poor responders continued HU treatment, emphasizing the need to improve overall therapeutic strategy. ....
The referenced article - a bit more difficult to read
HU Resistance/Intolerance Prognostic from Dr Gotlib
