After seeing so many CML patients suffer from the use of Hydroxyurea as initial CML treatment, I am compelled to explain why this very poor practice should end.
Hydroxyurea (HU) also called Hydrea should NOT be used for initial CML leukemia treatment under almost any circumstance. Even if the initial WBC is well over 300K, TKI drugs are still preferred for initial CML treatment instead of Hydroxyurea. TKI drugs selectively target the leukemic blood cells, resulting in an effective, orderly and controlled decline in leukemic blood cells while sparing and preserving the good blood cells necessary for recovery from CML.
Hydroxyurea is a chemotherapy drug which indiscriminately kills off blood cells, both leukemic cells and good blood cells. At CML diagnosis the good blood cells are already struggling due to the body's attempts to limit blood cell production, since only good blood cells respond to signals to slow down blood cell production. Using Hydroxyurea kills off these already struggling normal blood cells, and when the TKI drugs bring down overall WBC by eliminating vast numbers of leukemic blood cells, a crash landing of blood counts results. This leads to critically low blood counts with which the patient will struggle for a long time. This actually sets back CML treatment as drug breaks are often required due to the low blood counts. Long term myelosuppression (low blood counts) can result.
Hydroxyurea also causes a yo-yo effect with blood counts, masking the true nature of patient response to TKI drugs. Hydroxyurea can result in enhancing leukemic cell rebound after the initial steep drop in blood counts.
I cannot stress strongly enough that HYDROXYUREA SHOULD NOT BE USED FOR INITIAL CML TREATMENT. Let the TKI drug bring down blood counts in a controlled manner to prevent a crash landing into severe myelosuppression, and to prevent killing off the already struggling normal blood cells. Recovery from CML is highly dependent on having an adequate pool of normal blood cells to repopulate the blood with normal cells.
Edited by Trey, 09 November 2015 - 06:32 PM.