Hydroxyurea-associated platelet count oscillations in polycythemia vera: A report of four new cases and a review

David P. Steensma, Claire N. Harrison, Ayalew Tefferi

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Cyclic oscillations in the peripheral blood platelet count were recently described in two patients with polycythemia vera (PV) receiving therapy with hydroxyurea (HU). This phenomenon can make proper HU dosing very challenging and may be especially problematic in PV patients who are at risk for thrombohemorrhagic complications. In this report, we describe four new cases of HU-associated platelet oscillations in patients with PV and extend our observations on one of the two previously reported cases. We also review cyclic thrombocytosis within the broader context of periodic hematopoiesis. A thrombopoietin-mediated negative feedback loop is central to most models of periodic thrombopoiesis, but this is probably an oversimplification. It is possible that HU destabilizes the delicate balance of thrombopoietin/c-Mpl signaling in megakaryocytic lineage hematopoiesis that is already markedly altered in PV; this hypothesis remains speculative. For patients who develop oscillatory variation in their platelet counts associated with HU use, keeping the HU dose constant may result in damping or termination of the cycles. However, this strategy is not always successful.

Original languageEnglish (US)
Pages (from-to)1243-1253
Number of pages11
JournalLeukemia and Lymphoma
Volume42
Issue number6
DOIs
StatePublished - 2001

Fingerprint

Polycythemia Vera
Hydroxyurea
Platelet Count
Thrombopoietin
Hematopoiesis
Thrombopoiesis
Thrombocytosis
Blood Platelets

Keywords

  • Cyclic hematopoiesis
  • Hydroxyurea
  • Myeloproliferative disorders [therapy]
  • Platelet oscillation
  • Polycythemia vera

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Hydroxyurea-associated platelet count oscillations in polycythemia vera : A report of four new cases and a review. / Steensma, David P.; Harrison, Claire N.; Tefferi, Ayalew.

In: Leukemia and Lymphoma, Vol. 42, No. 6, 2001, p. 1243-1253.

Research output: Contribution to journalArticle

@article{b88f511239f04cfebbec5670c471be6d,
title = "Hydroxyurea-associated platelet count oscillations in polycythemia vera: A report of four new cases and a review",
abstract = "Cyclic oscillations in the peripheral blood platelet count were recently described in two patients with polycythemia vera (PV) receiving therapy with hydroxyurea (HU). This phenomenon can make proper HU dosing very challenging and may be especially problematic in PV patients who are at risk for thrombohemorrhagic complications. In this report, we describe four new cases of HU-associated platelet oscillations in patients with PV and extend our observations on one of the two previously reported cases. We also review cyclic thrombocytosis within the broader context of periodic hematopoiesis. A thrombopoietin-mediated negative feedback loop is central to most models of periodic thrombopoiesis, but this is probably an oversimplification. It is possible that HU destabilizes the delicate balance of thrombopoietin/c-Mpl signaling in megakaryocytic lineage hematopoiesis that is already markedly altered in PV; this hypothesis remains speculative. For patients who develop oscillatory variation in their platelet counts associated with HU use, keeping the HU dose constant may result in damping or termination of the cycles. However, this strategy is not always successful.",
keywords = "Cyclic hematopoiesis, Hydroxyurea, Myeloproliferative disorders [therapy], Platelet oscillation, Polycythemia vera",
author = "Steensma, {David P.} and Harrison, {Claire N.} and Ayalew Tefferi",
year = "2001",
doi = "10.1080/10428190127504",
language = "English (US)",
volume = "42",
pages = "1243--1253",
journal = "Leukemia and Lymphoma",
issn = "1042-8194",
publisher = "Informa Healthcare",
number = "6",

}

TY - JOUR

T1 - Hydroxyurea-associated platelet count oscillations in polycythemia vera

T2 - A report of four new cases and a review

AU - Steensma, David P.

AU - Harrison, Claire N.

AU - Tefferi, Ayalew

PY - 2001

Y1 - 2001

N2 - Cyclic oscillations in the peripheral blood platelet count were recently described in two patients with polycythemia vera (PV) receiving therapy with hydroxyurea (HU). This phenomenon can make proper HU dosing very challenging and may be especially problematic in PV patients who are at risk for thrombohemorrhagic complications. In this report, we describe four new cases of HU-associated platelet oscillations in patients with PV and extend our observations on one of the two previously reported cases. We also review cyclic thrombocytosis within the broader context of periodic hematopoiesis. A thrombopoietin-mediated negative feedback loop is central to most models of periodic thrombopoiesis, but this is probably an oversimplification. It is possible that HU destabilizes the delicate balance of thrombopoietin/c-Mpl signaling in megakaryocytic lineage hematopoiesis that is already markedly altered in PV; this hypothesis remains speculative. For patients who develop oscillatory variation in their platelet counts associated with HU use, keeping the HU dose constant may result in damping or termination of the cycles. However, this strategy is not always successful.

AB - Cyclic oscillations in the peripheral blood platelet count were recently described in two patients with polycythemia vera (PV) receiving therapy with hydroxyurea (HU). This phenomenon can make proper HU dosing very challenging and may be especially problematic in PV patients who are at risk for thrombohemorrhagic complications. In this report, we describe four new cases of HU-associated platelet oscillations in patients with PV and extend our observations on one of the two previously reported cases. We also review cyclic thrombocytosis within the broader context of periodic hematopoiesis. A thrombopoietin-mediated negative feedback loop is central to most models of periodic thrombopoiesis, but this is probably an oversimplification. It is possible that HU destabilizes the delicate balance of thrombopoietin/c-Mpl signaling in megakaryocytic lineage hematopoiesis that is already markedly altered in PV; this hypothesis remains speculative. For patients who develop oscillatory variation in their platelet counts associated with HU use, keeping the HU dose constant may result in damping or termination of the cycles. However, this strategy is not always successful.

KW - Cyclic hematopoiesis

KW - Hydroxyurea

KW - Myeloproliferative disorders [therapy]

KW - Platelet oscillation

KW - Polycythemia vera

UR - http://www.scopus.com/inward/record.url?scp=0035691873&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035691873&partnerID=8YFLogxK

U2 - 10.1080/10428190127504

DO - 10.1080/10428190127504

M3 - Article

C2 - 11911405

AN - SCOPUS:0035691873

VL - 42

SP - 1243

EP - 1253

JO - Leukemia and Lymphoma

JF - Leukemia and Lymphoma

SN - 1042-8194

IS - 6

ER -