{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:48:41Z","timestamp":1791388121516,"version":"4.3.3"},"reference-count":54,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2003,8,25]],"date-time":"2003-08-25T00:00:00Z","timestamp":1061769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2003,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Eighty\u2010three patients with various chronic myeloproliferative disorders [polycythemia vera (PV), essential thrombocytosis (ET), idiopathic myelofibrosis (IMF)] were analyzed for the occurrence of acute myeloid leukemia (AML) and myelodysplasia (MDS) during treatment with hydroxyurea (HU) alone or HU following treatment with busulphan (BU). A total of 58 patients (29 PV, 14 ET, 12 IMF, 3 unclassified) had been treated with HU. Thirty\u2010five of these patients had been treated with HU alone whereas 18 patients had received both HU and BU. The follow\u2010up period was 7.8 years. Twenty\u2010five patients had not been treated with HU. In this patient group, 4 patients had been treated with BU. The follow\u2010up period was 10.5 years. In the HU\u2010treated group (<jats:italic>n<\/jats:italic> = 58) 7 patients developed AML and 5 patients MDS. Five of the 12 patients had been treated with HU alone, and 4 patients had received both HU and BU. In the non\u2010HU\u2010treated group (<jats:italic>n<\/jats:italic> = 25) 1 patient with PV developed acute myeloid leukemia (AML). This patient had only been treated with phlebotomies. It is concluded that treatment with HU is leukemogenic, with an incidence of AML and MDS of approximately 14% when used alone. The incidence is markedly increased to about 30% when HU is preceded by treatment with BU. HU is not recommended for use in younger patients, in whom non\u2010leukemogenic agents such as \u03b1\u2010interferon and anagrelide should be used instead. Am. J. Hematol. 74:26\u201331, 2003. \u00a9 2003 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ajh.10375","type":"journal-article","created":{"date-parts":[[2003,8,27]],"date-time":"2003-08-27T13:39:22Z","timestamp":1061991562000},"page":"26-31","source":"Crossref","is-referenced-by-count":50,"title":["Acute leukemia and myelodysplasia in patients with a Philadelphia chromosome negative chronic myeloproliferative disorder treated with hydroxyurea alone or with hydroxyurea after busulphan"],"prefix":"10.1002","volume":"74","author":[{"given":"Iben","family":"Nielsen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans Carl","family":"Hasselbalch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2003,8,25]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.2830170402"},{"key":"e_1_2_1_3_2","first-page":"167","article-title":"Long\u2010term management of polycythaemia vera with hydroxyurea","volume":"23","author":"Kaplan ME","year":"1986","journal-title":"Semin Hematol"},{"key":"e_1_2_1_4_2","first-page":"156","article-title":"Acute leukemia in polycythemia vera","volume":"23","author":"Landaw SA","year":"1986","journal-title":"Semin Hematol"},{"key":"e_1_2_1_5_2","first-page":"177","article-title":"Essential thrombocythemia: an interim report from the Polycythemia Vera Study Group","volume":"23","author":"Murphy S","year":"1986","journal-title":"Semin Hematol"},{"key":"e_1_2_1_6_2","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1097\/00005792-198611000-00001","article-title":"Essential thrombocythaemia and leukemic transformation","volume":"6","author":"Sedlacck SM","year":"1986","journal-title":"Medicine"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-198703000-00012"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.1988.tb00212.x"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19880101)61:1<89::AID-CNCR2820610115>3.0.CO;2-0"},{"issue":"1","key":"e_1_2_1_10_2","first-page":"32","article-title":"Myelodysplastic syndrome and secondary acute leukemia after treatment of essential thrombocythemia with hydroxyurea","volume":"34","author":"Van den Anker\u2010Lugtenburg PJ","year":"1990","journal-title":"Am J Hematol"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0165-4608(90)90164-6"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.2830370110"},{"issue":"7","key":"e_1_2_1_13_2","first-page":"606","article-title":"Chronic myelomonocytic leukemia transformation in polycythemia vera","volume":"5","author":"Holcombe RF","year":"1991","journal-title":"Leukemia"},{"issue":"6","key":"e_1_2_1_14_2","first-page":"401","article-title":"Essential thrombocythemia and acute leukemia","volume":"78","author":"Ferrari D","year":"1993","journal-title":"Haematologica"},{"key":"e_1_2_1_15_2","first-page":"564","article-title":"Hydroxyurea and other myelosuppressive agents in the treatment of essential thrombocythaemia: analysis of leukemogenic potential","volume":"69","author":"Murphy S","year":"1993","journal-title":"Thromb Haemost"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1159\/000204260"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.1994.tb01303.x"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.1995.tb01621.x"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199504273321704"},{"key":"e_1_2_1_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8652(199602)51:2<137::AID-AJH7>3.0.CO;2-Z"},{"key":"e_1_2_1_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.2830340108"},{"key":"e_1_2_1_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8652(199605)52:1<42::AID-AJH7>3.0.CO;2-6"},{"issue":"2","key":"e_1_2_1_23_2","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1093\/ajcp\/106.2.206","article-title":"Acute lymphoblastic leukemia in a case of essential thrombocythemia","volume":"106","author":"Woronzoff\u2010Dashkoff KK","year":"1996","journal-title":"Am J Clin Pathol"},{"key":"e_1_2_1_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8652(199611)53:3<207::AID-AJH16>3.0.CO;2-A"},{"issue":"10","key":"e_1_2_1_25_2","first-page":"3552a","article-title":"Hydroxyurea\u2010related acute leukemia in essential thrombocythemia (ET). 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