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Chronic Myeloproliferative Disorder

A unified definition of clinical resistance/intolerance to hydroxyurea in essential thrombocythemia: results of a consensus process by an international working group

Leukemia volume 21, pages 277–280 (2007)Cite this article

A Corrigendum to this article was published on 25 April 2007

Abstract

A widely accepted definition of resistance or intolerance to hydroxyurea (HU) in patients with essential thrombocythemia (ET) is lacking. An international working group (WG) was convened to develop a consensus formulation of clinically significant criteria for defining resistance/intolerance to HU in ET. To this aim, an analytic hierarchy process (AHP), a multiple-attribute decision-making technique, was used. The steps consisted of selecting the candidate criteria for defining resistance/intolerance; identifying the motivations that could influence the preference of the WG for any individual criterion; comparing the candidate criteria in a pair-wise manner; and grading them according their ability to fulfill the motivations. Every step in the model was derived by questionnaires or group discussion. The WG proposed that the definition of resistance/intolerance should require the fulfillment of at least one of the following criteria: platelet count greater than 600 000/μl after 3 months of at least 2 g/day of HU (2.5 g/day in patients with a body weight over 80 kg); platelet count greater than 400 000/μl and WBC less than 2500/μl or Hb less than 10 g/dl at any dose of HU; presence of leg ulcers or other unacceptable muco-cutaneous manifestations at any dose of HU; HU-related fever.

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Acknowledgements

This work was based on an initiative of the European LeukemiaNet within the 6th European Community Framework Programme for Research and Technological Development. This work was supported by a grant from Shire.

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Authors and Affiliations

  1. Unit of Clinical Epidemiology and Center for the Study of Myelofibrosis, IRCCS Policlinico S. Matteo, Pavia, Italy

    G Barosi

  2. Servei d’Hematologia Clinica. Hospital del Mar. IMAS. IMIM. Universitat Autonoma, Barcelona, Spain

    C Besses

  3. Department of Hematology, University Hospital, Uppsala, Sweden

    G Birgegard

  4. Hematology Unit Beaujon Hospital, Clichy, France

    J Briere

  5. Hematology Department, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain

    F Cervantes

  6. Division of Hematology, Ospedali Riuniti di Bergamo, Bergamo, Italy

    G Finazzi & T Barbui

  7. Department of Internal Medicine, University of Vienna, Vienna, Austria

    H Gisslinger

  8. Department of Internal Medicine III, University of Ulm, Ulm, Germany

    M Griesshammer

  9. Hematology Unit, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy

    L Gugliotta

  10. Department of Haematology, St Thomas Hospital, London, UK

    C Harrison

  11. Department of Hematology, University of Southern Denmark, Odense University Hospital, Odense, Denmark

    H Hasselbalch

  12. Department of Internal Medicine III, Klinikum Mannheim, University of Heidelberg, Heidelberg, Germany

    E Lengfelder

  13. Henry Wellcome Laboratories for Medical Research, Academic Unit of Haematology, Sheffield, UK

    J T Reilly

  14. Department of Hematology, University Hospital Antwerp, Antwerp, Belgium

    J J Michiels

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  1. G Barosi
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Correspondence to G Barosi.

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Barosi, G., Besses, C., Birgegard, G. et al. A unified definition of clinical resistance/intolerance to hydroxyurea in essential thrombocythemia: results of a consensus process by an international working group. Leukemia 21, 277–280 (2007). https://doi.org/10.1038/sj.leu.2404473

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