Haemolytic anemia in a patient of Chronic myeloid leukemia: an unrecognized side-effect of Hydroxyurea?
Main Article Content
Keywords
Hydroxyurea, Hemolytic Anemia, Myeloproliferative Neoplasm, Side Effect
Abstract
Hydroxyurea (HU) is frequently used in the treatment of various myeloproliferative neoplasms (MPN) where it reduces cell proliferation by impairing DNA synthesis leading to decreased hematopoiesis. Herein we report a case of a 65-year-old female who was diagnosed with Chronic myeloid leukemia and developed severe hemolytic anemia requiring multiple packed red blood cell (RBC) transfusions while being treated with hydroxyurea. The hemolysis persisted until discontinuation of the drug. Common side-effects of HU like macrocytic anemia, leucopenia, and thrombocytopenia are well known but haemolytic anemia is a rare side-effect, not well known with only a handful of cases being described in the scientific literature so far.
References
2. Lugito NPH, Kurniawan A, Kurniawan YC, Yacobus E, Halim, E. Essential thrombocythemia, hemolyticanemia, and hepatic cirrhosis: could there be an association? Hematology Reports 2018; 10: 7394
3. Jabr FI, Shamseddine A, Taher A. Hydroxyurea-induced hemolyticanemia in a patient with essential thrombocythemia. American Journal of Hematology 2004; 77: 374–376.
4. Card RT, Lee JD, McGrath M, Valberg LS. The effect of hydroxyurea on erythropoiesis, erythrocyte survival, and erythrokinetics in the rabbit. Cancer Res 1968; 28:2027–2031.
5. Kennedy BJ, Yarbro JW. Metabolic and therapeutic effects of hydroxyurea in chronic myeloid leukemia. JAMA 1966; 195:1038– 1043.
6. Strouse JJ, Lanzkron S, Beach MC, Haywood C, Park H, Witkop C, Wilson RF, Bass EB, Segal JB. Hydroxyurea for sickle cell disease: a systematic review for efficacy and toxicity in children. Pediatrics 2008;122: 1332–1342.
7. Roa D, Kopsombut P, Aguinaga MP, Turner EA. Hydroxyurea-induced denaturation of normal and sickle cell hemoglobin in vitro. Journal of Clinical Laboratory Analysis 1977; 11:208– 213
8. Cortelazzo S, Viero P, Finazzi G, D’Emilio A, Rodeghiero F, Barbui T. Incidence and risk factors for thrombotic complications in a historical cohort of 100 patients with essential thrombocythemia. J Clin Oncol 1990; 8:556–562.
9. 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. doi: 10.1056/NEJM199504273321704.
10. Cornelisse AC, Bergkamp FJM, Griffioen-Keijzer A. Haemolytic anaemia: an unrecognised side effect of hydroxyurea? Br J Haematol. 2020 Mar;188(6):e80-e81. doi: 10.1111/bjh.16346.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This is an open-access journal and articles are distributed under the terms of the Creative Commons Attribution Non-Commercial Share-Alike License 4.0. This licence allows users to download and share, remix, tweak and build upon the article for non-commercial purposes, so long as the original authorship is acknowledged and the new creations are licensed under identical terms.