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The Use of Anagrelide in Myeloproliferative Neoplasms, with Focus on Essential Thrombocythemia
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
2016 (English)In: Current Hematologic Malignancy Reports, ISSN 1558-8211, E-ISSN 1558-822X, Vol. 11, no 5, p. 348-355Article, review/survey (Refereed) Published
Abstract [en]

Anagrelide (ANA) is a drug with specific platelet-lowering activity, used primarily in ET, registered as a second-line drug in essential thrombocythemia (ET) in Europe and in some countries as first-line therapy, in USA licensed by FDA for thrombocythemia in myeloproliferative neoplasms (MPN). The platelet-lowering efficacy is similar to that of hydroxycarbamide (HC), around 70 % complete response and 90 % partial response. Side effects are common, especially headache and tachycardia, but usually subside or disappear within a few weeks. Around 20 % of patients stop ANA therapy due to side effects or insufficient response. Studies of treatment patterns in Europe show that ANA is preferentially given to younger patients, probably because of the concern for a possible leukemogenic effect of the common first-line drug, HC. Only two randomized studies have compared the efficacy of ANA and HC in preventing thrombosis and haemorrhage, the larger of them showing a slightly better efficacy of HC, the other showing non-inferiority of ANA to HC. A recent observational 5-year study of 3600 patients shows a low and basically similar efficacy of ANA and other cytoreductive therapies in ET. ANA does not appear to inhibit fibrosis development, and probably due to its anticoagulation properties, the combination of ASA and ANA produces an increased rate of haemorrhage. Combination of ANA with HC or interferon (IFN) is feasible and effective in patients with insufficient platelet response to mono-therapy.

Place, publisher, year, edition, pages
2016. Vol. 11, no 5, p. 348-355
Keywords [en]
Anagrelide, Essential thrombocythemia, ET, Platelets
National Category
Hematology
Identifiers
URN: urn:nbn:se:uu:diva-309831DOI: 10.1007/s11899-016-0335-0ISI: 000384583100004PubMedID: 27497846OAI: oai:DiVA.org:uu-309831DiVA, id: diva2:1053052
Available from: 2016-12-08 Created: 2016-12-07 Last updated: 2017-11-29Bibliographically approved

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