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

G. Barosi, C. Besses, G. Birgegard, J. Briere, F. Cervantes, G. Finazzi, H. Gisslinger, M. Griesshammer, L. Gugliotta, C. Harrison, H. Hasselbalch, E. Lengfelder, J. T. Reilly, J. J. Michiels, T. Barbui

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    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 600000/μl after 3 months of at least 2g/day of HU (2.5g/day in patients with a body weight over 80kg); platelet count greater than 400000/μl and WBC less than 2500/μl or Hb less than 10g/dl at any dose of HU; presence of leg ulcers or other unacceptable muco-cutaneous manifestations at any dose of HU; HU-related fever.
    Original languageEnglish
    Pages (from-to)277-280
    JournalLeukemia
    Volume21
    Issue number2
    DOIs
    Publication statusPublished - 1 Jan 2007

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