{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:50:26Z","timestamp":1765212626148,"version":"3.46.0"},"reference-count":39,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>We describe a patient with post-essential thrombocythaemia myelofibrosis treated with intermittent hydroxyurea (Hu) therapy (20 mg\/Kg, given as a single dose, thrice weekly), achieving sustained disease control and regression of bone marrow fibrosis. Additionally, we discuss the efficacy of and rationale for use of intermittent Hu therapy in patients with myeloproliferative neoplasms, including those deemed to be Hu-resistant or intolerant to the commonly used continuous therapy.<\/jats:p>","DOI":"10.3390\/jcm14248641","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:20:29Z","timestamp":1765210829000},"page":"8641","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Regression of Post-Essential Thrombocythaemia Myelofibrosis with Intermittent Hydroxyurea Therapy: A Case Report"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0721-408X","authenticated-orcid":false,"given":"Arumugam","family":"Manoharan","sequence":"first","affiliation":[{"name":"Southern Sydney Haematology, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2500, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Tang","sequence":"additional","affiliation":[{"name":"Douglas Hanley Moir Pathology, Sydney, NSW 2093, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1002\/ajh.26751","article-title":"The International Consensus Classification of Myeloid Neoplasms and Acute Leukemia: Myeloproliferative Neoplasms","volume":"98","author":"Thiele","year":"2023","journal-title":"Am. J. Hematol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1002\/ajh.24221","article-title":"Myeloproliferative Neoplasms: A Decade of Discoveries and Treatment Advances","volume":"92","author":"Tefferi","year":"2016","journal-title":"Am. J. Hematol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1002\/ajh.27216","article-title":"Essential Thrombocythemia: 2024 Update on Diagnosis, Risk Stratification and Management","volume":"99","author":"Tefferi","year":"2024","journal-title":"Am. J. 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Clin. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1954","DOI":"10.1182\/blood.2022017423","article-title":"Myelofibrosis","volume":"141","author":"Passamonti","year":"2023","journal-title":"Blood"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1093\/labmed\/lmac074","article-title":"Essential Thrombocythemia and Post-essential Thrombocythemia Myelofibrosis: Updates on Diagnosis, Clinical Aspects and Management","volume":"54","author":"Puglianini","year":"2023","journal-title":"Lab. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1111\/j.1365-2141.1991.tb07989.x","article-title":"Management of Myelofibrosis with Intermittent Hydroxyurea","volume":"77","author":"Manoharan","year":"1991","journal-title":"Br. J. Haematol."},{"key":"ref_14","first-page":"1128","article-title":"European Consensus on Grading of Bone Marrow Fibrosis and Assessment of Cellularity","volume":"90","author":"Thiele","year":"2005","journal-title":"Haematologica"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1076029622111","DOI":"10.1177\/10760296221117482","article-title":"Thrombosis in Myeloproliferative Neoplasms: A Single Center Experience of Using Whole Blood Platelet Aggregation Studies for Risk Assessment and Thromboprophylaxis","volume":"28","author":"Manoharan","year":"2022","journal-title":"Clin. Appl. Thromb.\/Hemost."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1200\/JCO.1984.2.3.187","article-title":"Karnofsky Performance Status Revisited: Reliability, Validity and Guidelines","volume":"2","author":"Schag","year":"1984","journal-title":"J. Clin. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1002\/cncr.30325","article-title":"Differences in Treatment Goal and Perception of Symptoms Burden between Patients with Myeloproliferative Neoplasms (MPNs) and Hematologist\/Oncologists in the United States. 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Hematol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.clml.2019.09.601","article-title":"Treatment Patterns and Blood Counts in Patients with Polycythemia Vera Treated with Hydroxyurea in the United States: An Analysis from the REVEAL Study","volume":"20","author":"Grunwald","year":"2020","journal-title":"Clin. Lymphoma Myeloma Leuk."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1111\/bjh.19403","article-title":"Essential Thrombocythemia: A Contemporary Approach with New Drugs on the Horizon","volume":"204","year":"2024","journal-title":"Br. J. Haematol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1007\/s00277-023-05172-y","article-title":"Treatment of Hydroxyurea-Resistant\/Intolerant Polycythemia Vera: A Discussion of Best Practices","volume":"102","author":"Kuykendall","year":"2023","journal-title":"Ann. Hematol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e18565","DOI":"10.1200\/JCO.2017.35.15_suppl.e18565","article-title":"Treatment of Essential Thrombocythemia Patients Intolerant\/Resistant to Hydroxyurea","volume":"35","author":"Nejadnik","year":"2017","journal-title":"J. Clin. Oncol."},{"key":"ref_27","first-page":"1","article-title":"Hydroxyurea: An Old Drug in Need of New Clinical Trials in Myeloproliferative Neoplasms?","volume":"2","author":"Manoharan","year":"2024","journal-title":"Int. Internal. Med. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1007\/s002800050256","article-title":"Population Pharmacokinetics of Hydroxyurea in Cancer Patients","volume":"35","author":"Tracewell","year":"1995","journal-title":"Cancer Chemother. Pharmacol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"347","DOI":"10.2165\/00003088-199834050-00002","article-title":"Pharmacokinetics and Pharmacodynamics of Hydroxyurea","volume":"34","author":"Gwilt","year":"1998","journal-title":"Clin. Pharmacokinet."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2726","DOI":"10.1038\/leu.2017.169","article-title":"A Clinical-Molecular Prognostic Model to Predict Survival in Patients with Post Polycythemia Vera and Post Essential Thrombocythemia Myelofibrosis","volume":"31","author":"Passamonti","year":"2017","journal-title":"Leukemia"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1038\/leu.2017.297","article-title":"Performance of the Myelofibrosis Secondary to PV and ET-Prognostic Model (MYSEC-PM) in A Series of 262 Patients from the Spanish Registry of Myelofibrosis","volume":"32","author":"Pereira","year":"2018","journal-title":"Leukemia"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"698","DOI":"10.3390\/hematolrep16040067","article-title":"Treatment Strategies Used in Treating Myelofibrosis: State of the Art","volume":"16","author":"Martino","year":"2024","journal-title":"Hematol. Rep."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1007\/s11899-024-00744-9","article-title":"JAK Inhibitors for Myelofibrosis: Strengths and Limitations","volume":"19","author":"Thaw","year":"2024","journal-title":"Curr. Hematol. Malig. Rep."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1182\/blood.V51.2.189.189","article-title":"Agnogenic Myeloid Metaplasia: A Clonal Proliferation of Hemopoietic Stem Cells with Secondary Myelofibrosis","volume":"51","author":"Jacobson","year":"1978","journal-title":"Blood"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"660","DOI":"10.3324\/haematol.2015.141283","article-title":"Bone Marrow Fibrosis in Myelofibrosis: Pathogenesis, Prognosis and Targeted Strategies","volume":"101","author":"Zahr","year":"2016","journal-title":"Haematologica"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1111\/j.1600-0609.1984.tb00724.x","article-title":"Chemotherapy Resolves Symptoms and Reverses Marrow Fibrosis in Myelofibrosis","volume":"33","author":"Manoharan","year":"1984","journal-title":"Scand. J. Haematol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Editorial (1985). Reversible Myelofibrosis?. Lancet, 325, 497\u2013498.","DOI":"10.1016\/S0140-6736(85)92094-X"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1111\/j.1600-0609.1988.tb00812.x","article-title":"Ultrasonic Characterization of Splenic Tissue in Myelofibrosis: Further Evidence for Reversal of Fibrosis with Chemotherapy","volume":"40","author":"Manoharan","year":"1988","journal-title":"Eur. J. Haematol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1111\/j.1600-0609.1990.tb00344.x","article-title":"Reversal of Myelofibrosis by Hydroxyurea","volume":"44","author":"Lofvenberg","year":"1990","journal-title":"Eur. J. 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