Patterns of Hydroxyurea Prescription and Use in Routine Clinical Management of Polycythemia Vera: A Multicenter Chart Review StudyYahya Büyükaşık1, Rıdvan Ali2, Mehmet Turgut3, Güray Saydam4, Akif Selim Yavuz5, Ali Ünal6, Muhlis Cem Ar7, Orhan Ayyıldız8, Fevzi Altuntaş9, Müfide Okay1, Rafiye Çiftçiler1, Özgür Meletli3, Nur Soyer4, Metban Mastanzade5, Zeynep Güven6, Teoman Soysal7, Abdullah Karakuş8, Tuğçe Nur Yiğenoğlu10, Barış Uçar11, Ece Gökçen11, Tülin Tuğlular121Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
2Uludağ University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Bursa, Turkey
3Ondokuz Mayıs University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
4Ege University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
5İstanbul University, İstanbul Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
6Erciyes University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kayseri, Turkey
7İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
8Dicle University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Diyarbakır, Turkey
9Yıldırım Beyazıt University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Division of Hematology, Ankara, Turkey
10Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Division of Hematology, Ankara, Turkey
11Novartis Oncology, İstanbul, Turkey
12Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
Objective: This study aimed to evaluate real-life data on patterns of hydroxyurea prescription/use in polycythemia vera (PV).
Materials and Methods: This retrospective chart review study included PV patients who had received hydroxyurea therapy for at least 2 months after PV diagnosis. Data were collected from 10 representative academic medical centers.
Results: Of 657 patients, 50.9% were in the high-risk group (age ≥60 years and/or history of thromboembolic event). The median duration of hydroxyurea therapy was 43.40 months for all patients; 70.2% of the patients had ongoing hydroxyurea therapy at last followup. Hydroxyurea was discontinued in 22.4% of the patients; the most common reason was death (38.5%). The predicted time until hydroxyurea discontinuation was 187.8 months (standard error: ±21.7) for all patients. This duration was shorter in females (140.3±37.7 vs. 187.8±29.7) (p=0.08). This trend was also observed in surviving patients aged ≥50 years at hydroxyurea initiation (122.2±12.4 vs. 187.8±30.7, p=0.03). Among the patients who were still on hydroxyurea therapy, 40.3% had a hematocrit concentration of ≥45% at their last followup visit, and the rate of patients with at least one elevated blood cell count was 67.8%.
Conclusion: Hydroxyurea prescription patterns and treatment aims are frequently not in accordance with the guideline recommendations. Its discontinuation rate is higher in females.
Keywords: Polycythemia vera, Hydroxyurea, Treatment outcome
Polistemia Vera’nın Rutin Yönetiminde Hidroksiüre Reçete Etme ve Kullanma Şekilleri: Çok Merkezli Kayıt Tarama ÇalışmasıYahya Büyükaşık1, Rıdvan Ali2, Mehmet Turgut3, Güray Saydam4, Akif Selim Yavuz5, Ali Ünal6, Muhlis Cem Ar7, Orhan Ayyıldız8, Fevzi Altuntaş9, Müfide Okay1, Rafiye Çiftçiler1, Özgür Meletli3, Nur Soyer4, Metban Mastanzade5, Zeynep Güven6, Teoman Soysal7, Abdullah Karakuş8, Tuğçe Nur Yiğenoğlu10, Barış Uçar11, Ece Gökçen11, Tülin Tuğlular121Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
2Uludağ University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Bursa, Turkey
3Ondokuz Mayıs University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
4Ege University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
5İstanbul University, İstanbul Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
6Erciyes University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kayseri, Turkey
7İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
8Dicle University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Diyarbakır, Turkey
9Yıldırım Beyazıt University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Division of Hematology, Ankara, Turkey
10Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Division of Hematology, Ankara, Turkey
11Novartis Oncology, İstanbul, Turkey
12Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
Amaç: Polistemia vera’da (PV) hidroksiüre reçete etme/kullanma şekilleri hakkındaki gerçek yaşam verilerini değerlendirmek.
Gereç ve Yöntem: Bu retrospektif kayıt çalışmasına tanıdan sonra en az 2 ay hidroksiüre almış olan hastalar dahil edildi. Veriler ülkeyi temsil ettiği düşünülen 10 akademik tıp merkezinden toplandı.
Bulgular: Altı yüz elli yedi hastadan %50,9’u yüksek risk (yaş ≥60 yıl ve/veya tromboembolik olay öyküsü) grubundaydı. Tüm hastalarda ortanca hidroksiüre tedavi süresi 43,4 aydı. Hastaların %70,2’si son kontrol tarihlerinde halen hidroksiüre kullanmaktaydı. Hidroksiüre en sık neden (%38,5) ölüm olmak üzere hastaların %22,4’ünde kesilmişti. Tüm hasta grubunda hidroksiüre kesmek için ortanca süre 187,8 ay ±21,7 standart hata olarak hesaplandı. Bu süre kadınlarda (140,3±37,7) erkeklere (187,8±29,7) göre daha kısa idi (p=0,08). Bu eğilim hidroksiüre başlandığında 50 yaş ve üstünde olan ve son durumda hayatta olan hastalarda da gözlendi (122,2±12,4 ve 187,8±30,7, p=0,03). Hidroksiüre devam etmekte olan hastalarda son kontrolde ≥%45 hematokrit %40,3 ve en az bir artmış kan hücre düzeyi %67,8 oranında gözlendi.
Sonuç: Hidroksiüre reçete etme şekli ve tedavi hedefleri sıklıkla rehber önerilerine uymamaktadır. Hidroksiüre kesme oranı kadınlarda daha yüksektir.
Anahtar Kelimeler: Polistemia vera, Hidroksiüre, Tedavi sonucu
Yahya Büyükaşık, Rıdvan Ali, Mehmet Turgut, Güray Saydam, Akif Selim Yavuz, Ali Ünal, Muhlis Cem Ar, Orhan Ayyıldız, Fevzi Altuntaş, Müfide Okay, Rafiye Çiftçiler, Özgür Meletli, Nur Soyer, Metban Mastanzade, Zeynep Güven, Teoman Soysal, Abdullah Karakuş, Tuğçe Nur Yiğenoğlu, Barış Uçar, Ece Gökçen, Tülin Tuğlular. Patterns of Hydroxyurea Prescription and Use in Routine Clinical Management of Polycythemia Vera: A Multicenter Chart Review Study. Turk J Hematol. 2020; 37(3): 177-185
Corresponding Author: Yahya Büyükaşık, Türkiye |
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