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dc.contributor.authorAlvarez-Larrán, Alberto
dc.contributor.authorPérez-Encinas, Manuel
dc.contributor.authorFerrer-Marín, Francisca
dc.contributor.authorHernández-Boluda, Juan Carlos
dc.contributor.authorRamírez, María José
dc.contributor.authorMartinez-Lopez, Joaquin 
dc.contributor.authorMagro, Elena
dc.contributor.authorCruz, Yasmina
dc.contributor.authorMata, María Isabel
dc.contributor.authorAragües, Pilar
dc.contributor.authorFox, María Laura
dc.contributor.authorCuevas, Beatriz
dc.contributor.authorMontesdeoca, Sara
dc.contributor.authorHernández-Rivas, José Angel
dc.contributor.authorGarcía-Gutiérrez, Valentín
dc.contributor.authorGómez-Casares, María Teresa
dc.contributor.authorSteegmann, Juan Luis
dc.contributor.authorDurán, María Antonia
dc.contributor.authorGómez, Montse
dc.contributor.authorKerguelen, Ana
dc.contributor.authorBárez, Abelardo
dc.contributor.authorGarcía, Mari Carmen
dc.contributor.authorBoqué, Concepción
dc.contributor.authorRaya, José María
dc.contributor.authorMartínez, Clara
dc.contributor.authorAlbors, Manuel
dc.contributor.authorGarcía, Francesc
dc.contributor.authorBurgaleta, Carmen
dc.contributor.authorBesses, Carlos
dc.identifier.citationHaematologica. 2017 ;102(1):103-109.es_ES
dc.description.abstractHematocrit control below 45% is associated with a lower rate of thrombosis in polycythemia vera. In patients receiving hydroxyurea, this target can be achieved with hydroxyurea alone or with the combination of hydroxyurea plus phlebotomies. However, the clinical implications of phlebotomy requirement under hydroxyurea therapy are unknown. The aim of this study was to evaluate the need for additional phlebotomies during the first five years of hydroxyurea therapy in 533 patients with polycythemia vera. Patients requiring 3 or more phlebotomies per year (n=85, 16%) showed a worse hematocrit control than those requiring 2 or less phlebotomies per year (n=448, 84%). There were no significant differences between the two study groups regarding leukocyte and platelet counts. Patients requiring 3 or more phlebotomies per year received significantly higher doses of hydroxyurea than the remaining patients. A significant higher rate of thrombosis was found in patients treated with hydroxyurea plus 3 or more phlebotomies per year compared to hydroxyurea with 0-2 phlebotomies per year (20.5% vs. 5.3% at 3 years; P<0.0001). In multivariate analysis, independent risk factors for thrombosis were phlebotomy dependency (HR: 3.3, 95%CI: 1.5-6.9; P=0.002) and thrombosis at diagnosis (HR: 4.7, 95%CI: 2.3-9.8; P<0.0001). The proportion of patients fulfilling the European LeukemiaNet criteria of resistance/intolerance to hydroxyurea was significantly higher in the group requiring 3 or more phlebotomies per year (18.7% vs. 7.1%; P=0.001) mainly due to extrahematologic toxicity. In conclusion, phlebotomy requirement under hydroxyurea therapy identifies a subset of patients with increased proliferation of polycythemia vera and higher risk of thrombosis.es_ES
dc.description.sponsorshipWe are indebted to all members of GEMFIN participating in the Spanish Registry of Polycythemia Vera.es_ES
dc.publisherFondazione Ferrata Storti es_ES
dc.subject.meshAdolescent es_ES
dc.subject.meshAdult es_ES
dc.subject.meshAged es_ES
dc.subject.meshAged, 80 and over es_ES
dc.subject.meshBlood Cell Count es_ES
dc.subject.meshCombined Modality Therapy es_ES
dc.subject.meshDrug Resistance es_ES
dc.subject.meshFemale es_ES
dc.subject.meshHematocrit es_ES
dc.subject.meshHumans es_ES
dc.subject.meshHydroxyurea es_ES
dc.subject.meshMale es_ES
dc.subject.meshMiddle Aged es_ES
dc.subject.meshMultivariate Analysis es_ES
dc.subject.meshPhenotype es_ES
dc.subject.meshPolycythemia Vera es_ES
dc.subject.meshRegistries es_ES
dc.subject.meshRisk es_ES
dc.subject.meshSpain es_ES
dc.subject.meshThrombosis es_ES
dc.subject.meshTime Factors es_ES
dc.subject.meshTreatment Outcome es_ES
dc.subject.meshYoung Adult es_ES
dc.subject.meshPhlebotomy es_ES
dc.titleRisk of thrombosis according to need of phlebotomies in patients with polycythemia vera treated with hydroxyureaes_ES
dc.typejournal articlees_ES
dc.rights.licenseAtribución 4.0 Internacional*
dc.contributor.funderInstituto de Salud Carlos III 
dc.contributor.funderNovartis Farmaceutica
dc.repisalud.orgCNIOCNIO::Unidades técnicas::Unidad de Investigación Clínica de Tumores Hematológicos H12O-CNIOes_ES
dc.rights.accessRightsopen accesses_ES

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Atribución 4.0 Internacional
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