Janssen J J, Ossenkoppele G J
VU Medisch Centrum, afd. Hematologie, De Boelelaan 1117, 1081 HV Amsterdam.
Ned Tijdschr Geneeskd. 2003 Aug 2;147(31):1517-20.
Three male patients aged 52, 49 and 74 years who were treated with hydroxyurea for chronic myeloid leukaemia (CML) or essential thrombocytosis developed severely painful ulcers on the lower legs and feet after an interval varying from 4 months to 2.5 years. These ulcers only healed after discontinuation of the drug. This is an adverse effect of hydroxyurea that is not infrequently seen but is difficult to recognise. The precise pathogenesis is still unclear but micro-circulatory disorders and a direct cytostatic effect on the epidermal cells probably play a role. Often, the drug has already been used for several years before the ulcers develop. They are resistant to treatment unless the hydroxyurea is stopped. Alternatives to hydroxyurea are imatinib for the treatment of CML and interferon alpha-2a or anagrelide for essential thrombocytosis.
三名年龄分别为52岁、49岁和74岁的男性患者，因慢性粒细胞白血病（CML）或原发性血小板增多症接受羟基脲治疗，在4个月至2.5年不等的间隔期后，小腿和足部出现了严重疼痛的溃疡。这些溃疡仅在停药后才愈合。这是羟基脲的一种不良反应，虽不罕见但难以识别。确切的发病机制仍不清楚，但微循环障碍以及对表皮细胞的直接细胞抑制作用可能起了作用。通常，在溃疡出现之前，该药物已经使用了数年。除非停用羟基脲，否则这些溃疡对治疗具有抗性。对于CML的治疗，羟基脲的替代药物是伊马替尼；对于原发性血小板增多症，替代药物是干扰素α-2a或阿那格雷。
