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Do patients with polycythemia vera and resistance or intolerance to hydroxyurea present a special problem?

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If the patient is intolerant, sometimes those early symptoms include fatigue, fevers, night sweats, and then, of course, ulceration. The ulcers can happen any time, but intolerance like nausea, gastrointestinal upset, fevers, and fatigue can happen within days or weeks of starting therapy.

I think if you were looking at true failure, not because of intolerance, but truly that you can’t control the hematocrit, I usually give Hydrea® (hydroxyurea) 2 to 3 months with escalating doses before we call it a failure.

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Kim-Hien Dao, DO, PhD Assistant Professor of Medicine Knight Cancer Institute, Center for Hematologic Malignancies Oregon Health & Science University | Portland, OR
Dr Kim-Hien Dao serves as the Myelodysplastic Syndromes (MDS)–Myeloproliferative Neoplasms (MPN) Disease Group Leader at the Center for Hematologic Malignancies at Oregon Health & Science University. She is a member of the American Society of Hematology and Myeloproliferative Disorders (MPD) Research Consortium and is active in clinical research trials in MDS and MPNs. Dr Dao has an NIH-funded basic research program focusing on marrow failure in Fanconi anemia, myelodysplasia, and MPNs.