Cutaneous ulcers associated with hydroxyurea therapy in myeloproliferative disorders

F. Ravandi-Kashani, J. Cortes, P. Cohen, M. Talpaz, S. O'Brien, Avi Markowitz, H. Kantarjian

    Research output: Contribution to journalArticle

    25 Citations (Scopus)

    Abstract

    Hydroxyurea (HU) is an established chemotherapeutic agent in the treatment of myeloproliferative disorders (MPD) including chronic myelogenous leukemia (CML), polycythemia vera and essential thrombocythemia (ET). It is well tolerated, has minimal toxicities, and produces hematological response in most patients treated. Side effects of hydroxyurea are few and include myelosuppression, oral ulcers and skin rashes. Cutaneous toxicity is rare. This study aims to describe the occurrence of cutaneous ulcerations attributed to HU therapy in patients with MPD, and familiarize the oncology community with this unusual but disturbing toxicity of HU. Five patients with MPD receiving HU therapy at doses of 0.5 to 4 g/day who developed skin ulceration were reviewed (median age was 53 years). Three patients had Philadelphia positive CML, and two had ET. Cutaneous ulcers developed after a long period of HU therapy (median 36 months, range 7 to 96 months). The time after discontinuation of HU to the healing of the ulcers was 1 to 4 months. Ulcers developed mainly in the lower extremities particularly adjacent to the malleoli, indicating a possible relation to trauma. In conclusion, cutaneous ulceration represents a poorly recognized and rare HU-related side effect. Discontinuation of HU usually leads to slow resolution of the ulcers over several months. The etiology of this rare side effect remains poorly understood.

    Original languageEnglish (US)
    Pages (from-to)109-118
    Number of pages10
    JournalLeukemia and Lymphoma
    Volume35
    Issue number1-2
    StatePublished - 1999

    Fingerprint

    Skin Ulcer
    Myeloproliferative Disorders
    Hydroxyurea
    Ulcer
    Essential Thrombocythemia
    Skin
    Therapeutics
    Leukemia, Myelogenous, Chronic, BCR-ABL Positive
    Oral Ulcer
    Polycythemia Vera
    Exanthema
    Lower Extremity

    Keywords

    • Cutaneous ulcers
    • Hydroxyurea
    • Myeloproliferative disorders

    ASJC Scopus subject areas

    • Hematology
    • Oncology
    • Cancer Research

    Cite this

    Ravandi-Kashani, F., Cortes, J., Cohen, P., Talpaz, M., O'Brien, S., Markowitz, A., & Kantarjian, H. (1999). Cutaneous ulcers associated with hydroxyurea therapy in myeloproliferative disorders. Leukemia and Lymphoma, 35(1-2), 109-118.

    Cutaneous ulcers associated with hydroxyurea therapy in myeloproliferative disorders. / Ravandi-Kashani, F.; Cortes, J.; Cohen, P.; Talpaz, M.; O'Brien, S.; Markowitz, Avi; Kantarjian, H.

    In: Leukemia and Lymphoma, Vol. 35, No. 1-2, 1999, p. 109-118.

    Research output: Contribution to journalArticle

    Ravandi-Kashani, F, Cortes, J, Cohen, P, Talpaz, M, O'Brien, S, Markowitz, A & Kantarjian, H 1999, 'Cutaneous ulcers associated with hydroxyurea therapy in myeloproliferative disorders', Leukemia and Lymphoma, vol. 35, no. 1-2, pp. 109-118.
    Ravandi-Kashani F, Cortes J, Cohen P, Talpaz M, O'Brien S, Markowitz A et al. Cutaneous ulcers associated with hydroxyurea therapy in myeloproliferative disorders. Leukemia and Lymphoma. 1999;35(1-2):109-118.
    Ravandi-Kashani, F. ; Cortes, J. ; Cohen, P. ; Talpaz, M. ; O'Brien, S. ; Markowitz, Avi ; Kantarjian, H. / Cutaneous ulcers associated with hydroxyurea therapy in myeloproliferative disorders. In: Leukemia and Lymphoma. 1999 ; Vol. 35, No. 1-2. pp. 109-118.
    @article{5f6cc55c33bc416a85d4ff66aa3048e8,
    title = "Cutaneous ulcers associated with hydroxyurea therapy in myeloproliferative disorders",
    abstract = "Hydroxyurea (HU) is an established chemotherapeutic agent in the treatment of myeloproliferative disorders (MPD) including chronic myelogenous leukemia (CML), polycythemia vera and essential thrombocythemia (ET). It is well tolerated, has minimal toxicities, and produces hematological response in most patients treated. Side effects of hydroxyurea are few and include myelosuppression, oral ulcers and skin rashes. Cutaneous toxicity is rare. This study aims to describe the occurrence of cutaneous ulcerations attributed to HU therapy in patients with MPD, and familiarize the oncology community with this unusual but disturbing toxicity of HU. Five patients with MPD receiving HU therapy at doses of 0.5 to 4 g/day who developed skin ulceration were reviewed (median age was 53 years). Three patients had Philadelphia positive CML, and two had ET. Cutaneous ulcers developed after a long period of HU therapy (median 36 months, range 7 to 96 months). The time after discontinuation of HU to the healing of the ulcers was 1 to 4 months. Ulcers developed mainly in the lower extremities particularly adjacent to the malleoli, indicating a possible relation to trauma. In conclusion, cutaneous ulceration represents a poorly recognized and rare HU-related side effect. Discontinuation of HU usually leads to slow resolution of the ulcers over several months. The etiology of this rare side effect remains poorly understood.",
    keywords = "Cutaneous ulcers, Hydroxyurea, Myeloproliferative disorders",
    author = "F. Ravandi-Kashani and J. Cortes and P. Cohen and M. Talpaz and S. O'Brien and Avi Markowitz and H. Kantarjian",
    year = "1999",
    language = "English (US)",
    volume = "35",
    pages = "109--118",
    journal = "Leukemia and Lymphoma",
    issn = "1042-8194",
    publisher = "Informa Healthcare",
    number = "1-2",

    }

    TY - JOUR

    T1 - Cutaneous ulcers associated with hydroxyurea therapy in myeloproliferative disorders

    AU - Ravandi-Kashani, F.

    AU - Cortes, J.

    AU - Cohen, P.

    AU - Talpaz, M.

    AU - O'Brien, S.

    AU - Markowitz, Avi

    AU - Kantarjian, H.

    PY - 1999

    Y1 - 1999

    N2 - Hydroxyurea (HU) is an established chemotherapeutic agent in the treatment of myeloproliferative disorders (MPD) including chronic myelogenous leukemia (CML), polycythemia vera and essential thrombocythemia (ET). It is well tolerated, has minimal toxicities, and produces hematological response in most patients treated. Side effects of hydroxyurea are few and include myelosuppression, oral ulcers and skin rashes. Cutaneous toxicity is rare. This study aims to describe the occurrence of cutaneous ulcerations attributed to HU therapy in patients with MPD, and familiarize the oncology community with this unusual but disturbing toxicity of HU. Five patients with MPD receiving HU therapy at doses of 0.5 to 4 g/day who developed skin ulceration were reviewed (median age was 53 years). Three patients had Philadelphia positive CML, and two had ET. Cutaneous ulcers developed after a long period of HU therapy (median 36 months, range 7 to 96 months). The time after discontinuation of HU to the healing of the ulcers was 1 to 4 months. Ulcers developed mainly in the lower extremities particularly adjacent to the malleoli, indicating a possible relation to trauma. In conclusion, cutaneous ulceration represents a poorly recognized and rare HU-related side effect. Discontinuation of HU usually leads to slow resolution of the ulcers over several months. The etiology of this rare side effect remains poorly understood.

    AB - Hydroxyurea (HU) is an established chemotherapeutic agent in the treatment of myeloproliferative disorders (MPD) including chronic myelogenous leukemia (CML), polycythemia vera and essential thrombocythemia (ET). It is well tolerated, has minimal toxicities, and produces hematological response in most patients treated. Side effects of hydroxyurea are few and include myelosuppression, oral ulcers and skin rashes. Cutaneous toxicity is rare. This study aims to describe the occurrence of cutaneous ulcerations attributed to HU therapy in patients with MPD, and familiarize the oncology community with this unusual but disturbing toxicity of HU. Five patients with MPD receiving HU therapy at doses of 0.5 to 4 g/day who developed skin ulceration were reviewed (median age was 53 years). Three patients had Philadelphia positive CML, and two had ET. Cutaneous ulcers developed after a long period of HU therapy (median 36 months, range 7 to 96 months). The time after discontinuation of HU to the healing of the ulcers was 1 to 4 months. Ulcers developed mainly in the lower extremities particularly adjacent to the malleoli, indicating a possible relation to trauma. In conclusion, cutaneous ulceration represents a poorly recognized and rare HU-related side effect. Discontinuation of HU usually leads to slow resolution of the ulcers over several months. The etiology of this rare side effect remains poorly understood.

    KW - Cutaneous ulcers

    KW - Hydroxyurea

    KW - Myeloproliferative disorders

    UR - http://www.scopus.com/inward/record.url?scp=0032870024&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=0032870024&partnerID=8YFLogxK

    M3 - Article

    VL - 35

    SP - 109

    EP - 118

    JO - Leukemia and Lymphoma

    JF - Leukemia and Lymphoma

    SN - 1042-8194

    IS - 1-2

    ER -