Switched from hydroxy to anagrelide advice.

[Didgeridoo2]

Hello to all of you. I m 73 Yr. old woman with myelofibrosis. After a tough year with hospital admissions due to gallstones & sepsis ( recurrent,) & 5stone weight loss, l ve been taken off hydroxy due to anaemia, & needing too many blood transfusions. Have been put on Anagrelide & 1 epotein injection per week to try & prevent further transfusions. Consultant explained this leaves me prone to thrombotic events, but I do take Apixiban. My ignorance makes me wonder what happens to white platelets in my body, without the help of hydroxy. I now wonder is this what they call progression of condition? Not afraid but curious. Thank you for reading this post x

[hunter5582]

Not sure what you mean by "white platelets." If you are referring to White Blood Cells (AKA leukocytes) then there is a difference in what anagrelide does as compared to hydroxyurea.

Hydroxyurea reduces all three types of blood cells (PLT, WBC, RBC). It is an antimetabolite that inhibits ribonucleotide reductase, immediately inhibiting DNA synthesis in hematopoietic stem cells.

Anagrelide more specifically reduces platelets, The mechanism of action is that it disrupts postmitotic phase of megakaryocyte development, reducing platelet count.

I am not sure when momelotinib will be available where you are. This is the newly approved JAK inhibitor with a specific indication for MF with anemia. It may be worth asking your MPN care team.

Hope that answers your question.

[Didgeridoo2 in reply to hunter5582]

Thank you Hunter, yes white blood cells, & when I see consultant today, , will ask about memolotonib, though it ,s not available in Scotland yet. I understand now.

[lizzziep]

Hi, I was changed to Anagrelide from hydroxy in my 60’s, at first I had a few palpitations which soon settled down, then I used to get them occasionally a couple of hours after taking the capsules. It controlled my platelets well, most other counts were ok, including white cells. However I was very anaemic and had various treatments for that, which didn’t work! I was fine on it for 6 or 7 years until last year when I was diagnosed with MF at the age of 70, and am now on Ruxolitinib and EPO injections twice a week, I did have 3 blood transfusions last year but none for 3 months. Hope that helps you and all goes well for you.

[gset]

I have been on anagrelide for 7 years and was diagnosed with post ET MF. For me it has controlled my platelets better than HU (10 years) and inteferon. It gave me a new lease of life as I felt so run down and ill on the others due to recurrent infections and colds and sore throats etc. the palpitations were removed by spreading the dose through the day and I continue on it with no iron infusions yet, despite having had them whilst on HU. For me it gave me more more energy back. Best of luck