Hydroxyurea-Related Toxicity in 3,411 Patients with Ph'-Negative Mpn

Hydroxyurea (Hydroxycarbamide; HU) is commonly used for the longterm treatment of patients with Philadelphia-chromosome negative chronic myeloproliferative neoplasms (MPNs). It is considered a firstchoice agent for the treatment of these disorders as underlined by the European Leukemia Net Consensus Conference [ 1], although it is formally approved for this indication in some countries only. The drug is reportedly well tolerated in the large majority of subjects, although systemic and/ or localized toxicities have been reported. Consensus criteria for definition of "intolerance'' to HU have been described; patients who develop intolerance are candidate for second-line therapy and, more recently, for investigational drugs. However, no epidemiologic information about the occurrence of the most clinically significant HU-associated adverse events is yet available. In this study, the authors report on a multicenter series of 3,411 patients who were treated with HU among which 184, accounting for 5% of total, developed significant drug-related toxicities. These data provide an estimate of the frequency and a detailed characterization of clinically significant HU-related toxicities; these information have relevance for the management of MPN patients who require second-line therapy after developing HU-related intolerance.