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2020, Number 2

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Rev Hematol Mex 2020; 21 (2)

Hydroxyurea for secondary erythrocytosis treatment in old patients with contraindications for phlebotomy

Amaru R, Vera O, Paton D, Carrasco M, Amaru A

Language: Spanish
References: 66
Page: 77-85
PDF size: 248.64 Kb.


ABSTRACT

Objective: To evidence the applicability of hydroxyurea in the treatment of elderly patients with secondary erythrocytosis contraindicated for phlebotomy.
Material and Method: A prospective longitudinal study was done from March 2016 to April 2019 in subjects living in cities of La Paz (at 3600 masl) and El Alto (at 4000 masl), Bolivia, average age of 69 years and diagnoses of erythrocytosis secondary to cardiopulmonary disease with contraindication for phlebotomies. The treatment protocol considered atorvastatine 20 mg orally, acetylsalicylic acid 100 mg orally and hydroxyurea 500 mg orally to diminish blood hyperviscosity symptoms and reach Hb ‹ 18 g/dL.
Results: There were included 27 patients (14 women, 13 men). It was evidenced 48 months (n = 3) of the scheme atorvastatine and acetylsalicylic acid associated with hydroxyurea. The usual dose of hydroxyurea was 500 mg/day with a frequency of 7 times a week. Hyperviscosity symptoms decreased in 74% of patients from the first month, and 100% the sixth month of treatment. Hemoglobin decreased ‹ 22% of patients during the first month, 56% the sixth and 100% during the year following treatment. No adverse events were observed, leukocytes and platelets remained within normal ranges.
Conclusion: Myelosuppressive effect of low-dose hydroxyurea is favorable to treat secondary erythrocytosis of difficult management, it allows to reduce hemoglobin, hematocrit, blood hyperviscosity symptoms, and to avoid risks of iron deficiency due to phlebotomy.


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