";s:4:"text";s:6463:" This drug has a broad dose–response range, mild side effects, and theoretically little mutagenic risk. 1997;23(5):463-72. In cases of extreme thrombocytosis, therapeutic thrombocytapheresis can be a useful procedure. [Alvarez-Larrán A, Martínez-Avilés L, Hernández-Boluda JC, et al. It may be considered in patients for whom treatment with hydroxyurea has failed, in patients <65 years of age, or in patients who are pregnant or contemplating pregnancy. Its side effects are usually mild, and may include nausea, hair loss, discolored nails and ulcers in the mouth or on the legs. Essential thrombocythemia is a myeloproliferative disease with a high incidence of thrombotic complications, especially cerebral, myocardial, and peripheral arterial thromboses; pulmonary embolism and deep-vein thrombosis are less frequent.In a previous study we stratified patients with essential thrombocythemia according to risk factors for thrombosis. Discontinuation of the drug quickly reverses any unwanted myelosuppression.We conducted a prospective, randomized trial to assess whether hydroxyurea, given to keep the platelet count below 600,000 per cubic millimeter, reduces the incidence of thrombosis in patients with essential thrombocythemia who are at high risk for thrombotic complications.In a cohort of 198 patients seen at our two institutions who were given a diagnosis of essential thrombocythemia according to previously reported criteria,Base-line bleeding-time and coagulation studies, including measurement of the activated partial-thromboplastin time, one-stage prothrombin time, thrombin time, and fibrinogen levels, were performed according to standard methods. For mild vasomotor symptoms (e.g., headache, digital ischemia, erythromelalgia, livedo reticularis) and to decrease the risk of thrombosis, low-dose aspirin may be sufficient.Pregnant women who are asymptomatic and at low risk may be treated with aspirin to reduce the risk of placental thrombosis and spontaneous abortion.Because the prognosis is often good, potentially toxic treatments that lower the platelet count should be used sparingly and only when needed.Clopidogrel should be reserved for pregnant patients who have major contraindications to aspirin treatment, such as allergy or peptic ulcer disease.Interferon alfa-2b is effective for thrombocytosis associated with all myeloproliferative disorders. The two groups were matched for age, sex, and platelet count at randomization.
Our results confirm a previous observation that patients with platelet counts below 600,000 per cubic millimeter have a reduced rate of thrombosis.As in previous studies of essential thrombocythemiaThis study was not designed to assess the role of antiplatelet drugs in preventing vascular complications; many patients enrolled in this trial were already receiving antiplatelet treatment at the time of randomization. Peer-reviewed journal featuring in-depth articles to accelerate the transformation of health care delivery.Information, resources, and support needed to approach rotations - and life as a resident.Valuable tools for building a rewarding career in health care.Information and tools for librarians about site license offerings.The authorized source of trusted medical research and education for the Chinese-language medical community.The most trusted, influential source of new medical knowledge and clinical best practices in the world.Hydroxyurea for Patients with Essential Thrombocythemia and a High Risk of ThrombosisBase-Line Characteristics of 114 Patients with Essential Thrombocythemia.Mean (±SD) Platelet Counts of 114 Patients with Essential Thrombocythemia Treated with Hydroxyureaor Left Untreated.Incidence of Thrombosis in 114 Patients with Essential Thrombocythemia.Probability of Thrombosis-free Survival in 114 Patients with Essential Thrombocythemia Treated with Hydroxyurea or Left Untreated.Multivariate Analysis of Prognostic Factors for Thrombosis in 114 Patients with Essential Thrombocythemia.Base-Line Characteristics of 114 Patients with Essential Thrombocythemia.Mean (±SD) Platelet Counts of 114 Patients with Essential Thrombocythemia Treated with Hydroxyureaor Left Untreated.Incidence of Thrombosis in 114 Patients with Essential Thrombocythemia.Probability of Thrombosis-free Survival in 114 Patients with Essential Thrombocythemia Treated with Hydroxyurea or Left Untreated.Multivariate Analysis of Prognostic Factors for Thrombosis in 114 Patients with Essential Thrombocythemia. Hydroxyurea Versus Aspirin and Hydroxyurea in Essential Thrombocythemia (FAST) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Follow the links to read common uses, side effects, dosage … Primary Options; hydroxyurea: 15 mg/kg/day orally; Secondary Options
Hydroxyurea should be prescribed only by specialists familiar with its use and monitoring. Patient age can also be used to determine risk - for example, patients <40 years of age are at low risk, and patients 40 to 60 years of age are at intermediate risk.In low- or intermediate-risk patients, pharmacologic treatment is not usually required.
Both groups were followed for a median of 27 months. N Engl J Med.