Increased Incidence of Acute Leukemia in Polycythemia Vera Associated with Chlorambucil Therapy
- 19 February 1981
- journal article
- research article
- Published by Massachusetts Medical Society in New England Journal of Medicine
- Vol. 304 (8), 441-447
- https://doi.org/10.1056/nejm198102193040801
Abstract
In studies to determine the optimal treatment for polycythemia vera, 431 previously untreated patients whose disease met established diagnostic criteria were entered into a prospective, randomized controlled trial between 1967 and 1974. Three treatment regimens were used: phlebotomy alone, chlorambucil supplemented by phlebotomy, or radioactive phosphorus supplemented by phlebotomy. Despite minor differences in age and sex, the three groups were comparable in initial hematocrit, white-cell and platelet counts, and disease-related symptoms. The median duration of follow-up is now more than 6 1/2 years. As of February 15, 1980, there were no statistically significant differences in survival among the groups. However, the risk of acute leukemia in patients given chlorambucil was 2.3 times that in patients given radioactive phosphorus and 13 times that in patients treated with phlebotomy alone. The increased incidence of leukemia during chlorambucil treatment is statistically significant (P≤0.002); accordingly, the Polycythemia Vera Study Group has discontinued the use of chlorambucil in the treatment of polycythemia vera. (N Engl J Med. 1981; 304: 441–7.)This publication has 21 references indexed in Scilit:
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