Difference between revisions of "Essential thrombocythemia"
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| − | '''Use of this site is subject to you reading and agreeing with the terms set forth in the [[HemOnc.org_-_A_Hematology_Oncology_Wiki:General_disclaimer|disclaimer]].''' | + | '''Use of this site is subject to you reading and agreeing with the terms set forth in the [[HemOnc.org_-_A_Hematology_Oncology_Wiki:General_disclaimer|disclaimer]].''' |
| − | Is there a regimen missing from this list? | + | Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are [[How_to_contribute|invited to contribute to the site]]. |
{| class="wikitable" style="float:right; margin-right: 5px;" | {| class="wikitable" style="float:right; margin-right: 5px;" | ||
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| − | |<div style="background-color: #66FF66; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] | + | |<div style="background-color: #66FF66; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Regimen |limit=10000|format=sum}} regimens on this page</b></font></div> |
| − | <div style="background-color: #66CCFF; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] | + | <div style="background-color: #66CCFF; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} variants on this page</b></font></div> |
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{{TOC limit|limit=3}} | {{TOC limit|limit=3}} | ||
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| − | + | ====Therapy==== | |
| − | *[[Anagrelide (Agrylin)]] 0.5 mg PO twice | + | *[[Anagrelide (Agrylin)]] 0.5 mg PO twice per day ("Doses were subsequently adjusted to maintain the platelet count at less than 400,000 per cubic millimeter.") |
| − | *[[Aspirin]] 75 mg (100 mg in Australia) PO once | + | *[[Aspirin]] 75 mg (100 mg in Australia) PO once per day |
===Regimen #2 {{#subobject:abf053|Variant=1}}=== | ===Regimen #2 {{#subobject:abf053|Variant=1}}=== | ||
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| − | + | ====Therapy==== | |
| − | *[[Anagrelide (Agrylin)]] 0.5 mg PO twice | + | *[[Anagrelide (Agrylin)]] 0.5 mg PO twice per day ("increased until maintenance of the platelet count at normal (<=450 x 10<sup>9</sup>/L) or close to normal levels (>450 x 10<sup>9</sup>/L to 600 x 10<sup>9</sup>/L)") |
*Neither [[aspirin]] nor [[Clopidogrel (Plavix)]] were required in the study, but patients who were already taking either drug for at least two weeks were allowed to continue taking it during the study per investigator discretion | *Neither [[aspirin]] nor [[Clopidogrel (Plavix)]] were required in the study, but patients who were already taking either drug for at least two weeks were allowed to continue taking it during the study per investigator discretion | ||
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# Harrison CN, Campbell PJ, Buck G, Wheatley K, East CL, Bareford D, Wilkins BS, van der Walt JD, Reilly JT, Grigg AP, Revell P, Woodcock BE, Green AR; United Kingdom Medical Research Council Primary Thrombocythemia 1 Study. Hydroxyurea compared with anagrelide in high-risk essential thrombocythemia. N Engl J Med. 2005 Jul 7;353(1):33-45. [http://www.nejm.org/doi/full/10.1056/NEJMoa043800 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/16000354 PubMed] content property of [http://hemonc.org HemOnc.org] | # Harrison CN, Campbell PJ, Buck G, Wheatley K, East CL, Bareford D, Wilkins BS, van der Walt JD, Reilly JT, Grigg AP, Revell P, Woodcock BE, Green AR; United Kingdom Medical Research Council Primary Thrombocythemia 1 Study. Hydroxyurea compared with anagrelide in high-risk essential thrombocythemia. N Engl J Med. 2005 Jul 7;353(1):33-45. [http://www.nejm.org/doi/full/10.1056/NEJMoa043800 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/16000354 PubMed] content property of [http://hemonc.org HemOnc.org] | ||
<!-- Presented in parts in abstract form at the 50th annual meeting of the American Society of Hematology, December 7, 2008. --> | <!-- Presented in parts in abstract form at the 50th annual meeting of the American Society of Hematology, December 7, 2008. --> | ||
| − | # Gisslinger H, Gotic M, Holowiecki J, Penka M, Thiele J, Kvasnicka HM, Kralovics R, Petrides PE; for all members of the ANAHYDRET Study Group. Anagrelide compared with hydroxyurea in WHO-classified essential thrombocythemia: the ANAHYDRET Study, a randomized controlled trial. Blood. 2013 Mar 7;121(10):1720-8 | + | # Gisslinger H, Gotic M, Holowiecki J, Penka M, Thiele J, Kvasnicka HM, Kralovics R, Petrides PE; for all members of the ANAHYDRET Study Group. Anagrelide compared with hydroxyurea in WHO-classified essential thrombocythemia: the ANAHYDRET Study, a randomized controlled trial. Blood. 2013 Mar 7;121(10):1720-8. Epub 2013 Jan 11. [http://bloodjournal.hematologylibrary.org/content/121/10/1720.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/23315161 PubMed] |
==Aspirin & Hydroxyurea {{#subobject:762af3|Regimen=1}}== | ==Aspirin & Hydroxyurea {{#subobject:762af3|Regimen=1}}== | ||
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| − | + | ====Chemotherapy==== | |
| − | *[[Hydroxyurea (Hydrea)]] 500-1000 mg PO once | + | *[[Hydroxyurea (Hydrea)]] 500-1000 mg PO once per day ("Doses were subsequently adjusted to maintain the platelet count at less than 400,000 per cubic millimeter.") |
| − | *[[Aspirin]] 75 mg (100 mg in Australia) PO once | + | *[[Aspirin]] 75 mg (100 mg in Australia) PO once per day |
===Regimen #2 {{#subobject:53255b|Variant=1}}=== | ===Regimen #2 {{#subobject:53255b|Variant=1}}=== | ||
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| − | + | ====Chemotherapy==== | |
| − | *[[Hydroxyurea (Hydrea)]] 1500 mg PO once | + | *[[Hydroxyurea (Hydrea)]] 1500 mg PO once per day ("increased until maintenance of the platelet count at normal (<=450 x 10<sup>9</sup>/L) or close to normal levels (>450 x 10<sup>9</sup>/L to 600 x 10<sup>9</sup>/L)") |
*Neither [[aspirin]] nor [[Clopidogrel (Plavix)]] were required in the study, but patients who were already taking either drug for at least two weeks were allowed to continue taking it during the study per investigator discretion | *Neither [[aspirin]] nor [[Clopidogrel (Plavix)]] were required in the study, but patients who were already taking either drug for at least two weeks were allowed to continue taking it during the study per investigator discretion | ||
| Line 136: | Line 136: | ||
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|} | |} | ||
| − | + | ====Chemotherapy==== | |
*[[Hydroxyurea (Hydrea)]] 15 mg/kg/day PO | *[[Hydroxyurea (Hydrea)]] 15 mg/kg/day PO | ||
**Doses were subsequently adjusted to maintain the platelet count at less than 600,000 per cubic millimeter without lowering the white-cell count below 4000 per cubic millimeter | **Doses were subsequently adjusted to maintain the platelet count at less than 600,000 per cubic millimeter without lowering the white-cell count below 4000 per cubic millimeter | ||
| Line 193: | Line 193: | ||
''Quintás-Cardama et al. 2009 do not provide guidance on dose escalation or target dosing.'' | ''Quintás-Cardama et al. 2009 do not provide guidance on dose escalation or target dosing.'' | ||
| − | + | ====Immunotherapy==== | |
*[[Peginterferon alfa-2a (Pegasys)]] 90 mcg SC once per week | *[[Peginterferon alfa-2a (Pegasys)]] 90 mcg SC once per week | ||
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''Verger et al. 2015 do not specify a protocol but rather point to the European LeukemiaNet guidelines from 2011. All patients in this study had CALR mutations.'' | ''Verger et al. 2015 do not specify a protocol but rather point to the European LeukemiaNet guidelines from 2011. All patients in this study had CALR mutations.'' | ||
| − | + | ====Immunotherapy==== | |
*[[Peginterferon alfa-2a (Pegasys)]] | *[[Peginterferon alfa-2a (Pegasys)]] | ||
Revision as of 19:57, 21 August 2016
Use of this site is subject to you reading and agreeing with the terms set forth in the disclaimer.
Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are invited to contribute to the site.
8 regimens on this page
9 variants on this page
|
Untreated
Aspirin & Anagrelide
| back to top |
Regimen #1
| Study | Evidence | Comparator |
| Harrison et al. 2005 (MRC PT-1) | Phase III | Aspirin & Hydroxyurea |
Therapy
- Anagrelide (Agrylin) 0.5 mg PO twice per day ("Doses were subsequently adjusted to maintain the platelet count at less than 400,000 per cubic millimeter.")
- Aspirin 75 mg (100 mg in Australia) PO once per day
Regimen #2
| Study | Evidence | Comparator |
| Gisslinger et al. 2013 (ANAHYDRET) | Phase III | Hydroxyurea +/- Aspirin |
Therapy
- Anagrelide (Agrylin) 0.5 mg PO twice per day ("increased until maintenance of the platelet count at normal (<=450 x 109/L) or close to normal levels (>450 x 109/L to 600 x 109/L)")
- Neither aspirin nor Clopidogrel (Plavix) were required in the study, but patients who were already taking either drug for at least two weeks were allowed to continue taking it during the study per investigator discretion
References
- Harrison CN, Campbell PJ, Buck G, Wheatley K, East CL, Bareford D, Wilkins BS, van der Walt JD, Reilly JT, Grigg AP, Revell P, Woodcock BE, Green AR; United Kingdom Medical Research Council Primary Thrombocythemia 1 Study. Hydroxyurea compared with anagrelide in high-risk essential thrombocythemia. N Engl J Med. 2005 Jul 7;353(1):33-45. link to original article contains verified protocol PubMed content property of HemOnc.org
- Gisslinger H, Gotic M, Holowiecki J, Penka M, Thiele J, Kvasnicka HM, Kralovics R, Petrides PE; for all members of the ANAHYDRET Study Group. Anagrelide compared with hydroxyurea in WHO-classified essential thrombocythemia: the ANAHYDRET Study, a randomized controlled trial. Blood. 2013 Mar 7;121(10):1720-8. Epub 2013 Jan 11. link to original article contains verified protocol PubMed
Aspirin & Hydroxyurea
| back to top |
Regimen #1
| Study | Evidence | Comparator |
| Harrison et al. 2005 (MRC PT-1) | Phase III | Aspirin & Anagrelide |
Chemotherapy
- Hydroxyurea (Hydrea) 500-1000 mg PO once per day ("Doses were subsequently adjusted to maintain the platelet count at less than 400,000 per cubic millimeter.")
- Aspirin 75 mg (100 mg in Australia) PO once per day
Regimen #2
| Study | Evidence | Comparator |
| Gisslinger et al. 2013 (ANAHYDRET) | Phase III | Anagrelide +/- Aspirin |
Chemotherapy
- Hydroxyurea (Hydrea) 1500 mg PO once per day ("increased until maintenance of the platelet count at normal (<=450 x 109/L) or close to normal levels (>450 x 109/L to 600 x 109/L)")
- Neither aspirin nor Clopidogrel (Plavix) were required in the study, but patients who were already taking either drug for at least two weeks were allowed to continue taking it during the study per investigator discretion
References
- Harrison CN, Campbell PJ, Buck G, Wheatley K, East CL, Bareford D, Wilkins BS, van der Walt JD, Reilly JT, Grigg AP, Revell P, Woodcock BE, Green AR; United Kingdom Medical Research Council Primary Thrombocythemia 1 Study. Hydroxyurea compared with anagrelide in high-risk essential thrombocythemia. N Engl J Med. 2005 Jul 7;353(1):33-45. link to original article contains verified protocol PubMed
- Gisslinger H, Gotic M, Holowiecki J, Penka M, Thiele J, Kvasnicka HM, Kralovics R, Petrides PE; for all members of the ANAHYDRET Study Group. Anagrelide compared with hydroxyurea in WHO-classified essential thrombocythemia: the ANAHYDRET Study, a randomized controlled trial. Blood. 2013 Mar 7;121(10):1720-8. Epub 2013 Jan 11. link to original article contains verified protocol PubMed
Hydroxyurea (Hydrea)
| back to top |
Regimen
| Study | Evidence | Comparator |
| Cortelazzo et al. 1995 | Phase III | Observation |
Chemotherapy
- Hydroxyurea (Hydrea) 15 mg/kg/day PO
- Doses were subsequently adjusted to maintain the platelet count at less than 600,000 per cubic millimeter without lowering the white-cell count below 4000 per cubic millimeter
References
- Cortelazzo S, Finazzi G, Ruggeri M, Vestri O, Galli M, Rodeghiero F, Barbui T. Hydroxyurea for patients with essential thrombocythemia and a high risk of thrombosis. N Engl J Med. 1995 Apr 27;332(17):1132-6. link to original article contains verified protocol PubMed
Observation
| back to top |
Regimen
| Study | Evidence | Comparator |
| Cortelazzo et al. 1995 | Phase III | Hydroxyurea |
No active treatment; used as a comparator arm.
References
- Cortelazzo S, Finazzi G, Ruggeri M, Vestri O, Galli M, Rodeghiero F, Barbui T. Hydroxyurea for patients with essential thrombocythemia and a high risk of thrombosis. N Engl J Med. 1995 Apr 27;332(17):1132-6. link to original article contains verified protocol PubMed
Peginterferon alfa-2a (Pegasys)
| back to top |
Regimen
| Study | Evidence |
| Quintás-Cardama et al. 2009 | Phase II |
Quintás-Cardama et al. 2009 do not provide guidance on dose escalation or target dosing.
Immunotherapy
- Peginterferon alfa-2a (Pegasys) 90 mcg SC once per week
Unspecified duration
References
- Quintás-Cardama A, Kantarjian H, Manshouri T, Luthra R, Estrov Z, Pierce S, Richie MA, Borthakur G, Konopleva M, Cortes J, Verstovsek S. Pegylated interferon alfa-2a yields high rates of hematologic and molecular response in patients with advanced essential thrombocythemia and polycythemia vera. J Clin Oncol. 2009 Nov 10;27(32):5418-24. Epub 2009 Oct 13. link to original article contains protocol PubMed
- Update: Quintás-Cardama A, Abdel-Wahab O, Manshouri T, Kilpivaara O, Cortes J, Roupie AL, Zhang SJ, Harris D, Estrov Z, Kantarjian H, Levine RL, Verstovsek S. Molecular analysis of patients with polycythemia vera or essential thrombocythemia receiving pegylated interferon α-2a. Blood. 2013 Aug 8;122(6):893-901. Epub 2013 Jun 19. link to original article PubMed
Relapsed/Refractory
Peginterferon alfa-2a (Pegasys)
| back to top |
Regimen
| Study | Evidence |
| Verger et al. 2015 | Observational |
Verger et al. 2015 do not specify a protocol but rather point to the European LeukemiaNet guidelines from 2011. All patients in this study had CALR mutations.
Immunotherapy
References
- Verger E, Cassinat B, Chauveau A, Dosquet C, Giraudier S, Schlageter MH, Ianotto JC, Yassin MA, Al-Dewik N, Carillo S, Legouffe E, Ugo V, Chomienne C, Kiladjian JJ. Clinical and molecular response to interferon-α therapy in essential thrombocythemia patients with CALR mutations. Blood. 2015 Dec 10;126(24):2585-91. Epub 2015 Oct 20. link to original article does not contain protocol PubMed