Australian and New Zealand Journal of MedicineVolume 29, Issue 1 p. 102-103 Hypercalcaemia caused by Pneumocystis carinii pneumonia while in leukaemic remission A. K. MILLS, A. K. MILLS Haematology RegistrarSearch for more papers by this authorS. J. WRIGHT, S. J. WRIGHT Clinical HaematologistSearch for more papers by this authorK. M. TAYLOR, K. M. TAYLOR Director, Division of Cancer Services, Department of HaematologySearch for more papers by this authorJ. G. McCORMACK, J. G. McCORMACK Director, Infectious Diseases, Department of Medicine, Mater Adult Hospital, Brisbane, Qld.Search for more papers by this author A. K. MILLS, A. K. MILLS Haematology RegistrarSearch for more papers by this authorS. J. WRIGHT, S. J. WRIGHT Clinical HaematologistSearch for more papers by this authorK. M. TAYLOR, K. M. TAYLOR Director, Division of Cancer Services, Department of HaematologySearch for more papers by this authorJ. G. McCORMACK, J. G. McCORMACK Director, Infectious Diseases, Department of Medicine, Mater Adult Hospital, Brisbane, Qld.Search for more papers by this author First published: 25 March 2008 https://doi.org/10.1111/j.1445-5994.1999.tb01604.xCitations: 12AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume29, Issue1February 1999Pages 102-103 RelatedInformation

BACKGROUND:Essential thrombocythaemia (ET) has an associated risk of thrombotic and haemorrhagic complications, which can be minimised by control of the platelet count. Anagrelide selectively lowers the platelet count, however, there is little Australasian experience with its use and scant data on symptom control.AIMS:To evaluate the efficacy of anagrelide for platelet reduction and symptom control in a broad cohort of patients with well-defined ET, and to determine the safety and tolerability in such a population.METHODS:Seventeen patients with ET and a platelet count > 600 x 10(9)/L were prospectively enrolled. The evaluable four males and 12 females with a median age of 58 years (range 14-79) included ten patients (63%) previously treated with two or more agents and 12 patients (75%) who had failed other therapies. The median follow-up was seven months (range 15 days to 36 months).RESULTS:Anagrelide, in an average dose of 1.9 mg/day, reduced the platelet count from a mean of 728 x 10(9)/L (95% CI 611-845 x 10(9)/L) to 412 x 10(9)/L (95% CI 319-504 x 10(9)/L) (p < 0.001) and maintained it at this level. Fourteen patients (88%) had a platelet reduction to < 600 x 10(9)/L. All symptomatic patients had improvement in symptoms attributable to thrombocythaemia. There were three haemorrhagic and three thrombotic episodes in a total of three patients (19%), including one death from an intracerebral haemorrhage. Six patients (37%) were removed from therapy due to toxicity after a median of 151 days. Side effects included palpitations, abdominal pain and cough.CONCLUSIONS:Anagrelide is efficacious and safe in ET, both for platelet and symptom control. Minor side effects are common, however, tend to occur early and resolve spontaneously in most cases.

Alpha-interferon (alpha-IFN) therapy is an effective agent in early chronic phase (ECP) chronic myeloid leukemia (CML), achieving hematologic control in the majority and major cytogenetic response (MCR) (reduction in Ph' +ve metaphases to < 35%) in a substantial minority. Currently no pretreatment markers exist to ascertain likelihood of meaningful response. The site of breakpoint in M-bcr and relationship to prognosis is controversial. Studies have been hampered by variation in definition of breakpoint and difference in treatment protocols. In this study of ECP CML patients, Southern analysis and reverse transcription polymerase chain reaction (RT-PCR) were used to determine breakpoint location. Patients received alpha-IFN (9 x 10(6) units/day) and dose-adjusted hydroxyurea (HU) to maintain granulocyte count between 1.0-2.0 x 10(9)/l for 6 months or more. Twelve of 31 patients entered on the study achieved a MCR. The Sokal index did not predict for cytogenetic response to alpha-IFN. Eight of 11 patients with 5' breakpoint achieved MCR compared to only four of 20 patients with 3' breakpoint (P = 0.007). These results suggest site of M-bcr rearrangement may be predictive of response to alpha-IFN therapy. If verified by further study, this may allow more appropriate use of alpha-IFN with respect to other modalities such as allogeneic transplant.