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Previous Volume 332:1132-1137 April 27, 1995 Number 17 Next

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ABSTRACT

Background Abnormalities in the number and function of platelets may contribute to thromboembolic complications in patients with essential thrombocythemia. We assessed whether maintaining the platelet count below 600,000 per cubic millimeter with hydroxyurea reduces the incidence of thrombosis in patients with essential thrombocythemia and a high risk of thrombosis.

Methods A total of 114 patients with essential thrombocythemia (77 women and 37 men; median age, 68 years; range, 40 to 85) and a median platelet count of 788,000 per cubic millimeter (range, 533,000 to 1,240,000 per cubic millimeter) were randomly assigned to receive hydroxyurea (56 patients) or no myelosuppressive therapy (58 patients). Ninety-seven (85 percent) were over 60 years old, and 52 (46 percent) had had thrombosis. The two groups were matched for age, sex, and platelet count at randomization. Antiplatelet prophylaxis with aspirin or ticlopidine was not stopped. Follow-up lasted a median of 27 months in both groups.

Results Two patients (3.6 percent) treated with hydroxyurea had thrombotic episodes (one stroke and one myocardial infarction), whereas 14 patients (24 percent) in the control group had thrombotic episodes (one stroke, five transient ischemic attacks, five peripheral arterial occlusions, one deep-vein thrombosis, and two cases of superficial thrombophlebitis). The difference (20.4 percentage points; 95 percent confidence interval, 8.5 to 32 percent) was statistically significant (chi-square with Yates' correction, 8.3; 1 df; P = 0.003).

Conclusions Hydroxyurea is effective in preventing thrombosis in high-risk patients with essential thrombocythemia.

Source Information

From the Division of Hematology, Ospedali Riuniti di Bergamo, Bergamo (S.C., G.F., O.V., M.G., T.B.), and the Division of Hematology, Ospedale Civile S. Bortolo di Vicenza, Vicenza (M.R., F.R.) — both in Italy.

Address reprint requests to Prof. Barbui at the Divisione di Ematologia, Ospedali Riuniti di Bergamo, Largo Barozzi 1, 24100 Bergamo, Italy.

Full Text of this Article

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Hydroxyurea in Essential Thrombocytosis
van Genderen P., Michiels J. J., Ring T., Feiner R. H., Cortelazzo S., Finazzi G., Barbui T.
Extract | Full Text  
N Engl J Med 1995; 333:802-803, Sep 21, 1995. Correspondence

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