Hydroxyurea-Induced Leg Ulcers Treated with Apligraf

Flores, Francisco; Eaglstein, William; Kirsner, Robert S.

doi:10.7326/0003-4819-132-5-200003070-00017

Cited by 30 publications

(20 citation statements)

References 3 publications

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“…This observation is in agreement with the findings of a few other authors [5,19]. There have been various promising treatment modalities which have been recently published which may make it totally unnecessary to discontinue the hydroxyurea medication when an ulcer develops [22,23].…”

Section: Discussionsupporting

confidence: 94%

Leg ulcer in hydroxyurea-treated patients

Poros¹,

Nádasdy²

2000

Haematologia

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A cutaneous ulcer is a lesser known complication of hydroxyurea treatment. Out of 39 patients [18 polycythaemia vera (PV), 13 essential thrombocythaemia (ET), 4 chronic myeloid leukemia (CML), 4 undefined myeloproliferative diseases (MPD)] treated with hydroxyurea, 6 (4ET, 1PV, 1CML) developed a cutaneous ulcer during a period of less that 2 years' treatment. In all but one of the patients the ulcers were situated in the ankle region. At the time of onset of ulceration, none of them had extreme values in their peripheral blood counts. All had one or more of the predisposing factors such as minor trauma or mild varicosity. None of the patients had any alteration in arterial or venous circulation when examined by non-invasive means. No hyperviscosity was found as measured by capillary viscosimeter. The ulcers were cured in three patients without discontinuation of the drug. One patient later developed an ulcer on the other leg. The ulcers healed in two patients only after having stopped the hydroxyurea medication. One patient still had the ulcer when she succumbed to the underlying CML in transformation. In conclusion, cutaneous, ulceration of the leg is relatively common during hydroxyurea therapy. Predisposing factors are also involved in its development. Its healing does not necessarily require the discontinuation of the drug.

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Section: Discussionsupporting

confidence: 94%

Leg ulcer in hydroxyurea-treated patients

Poros¹,

Nádasdy²

2000

Haematologia

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“…Although this is only one case report of the use of Apligraf ® for pyoderma gangrenosum, the advantage of using a readily available skin substitute in this particular instance is that it avoids the necessity of harvesting autologous skin for expansion and the subsequent possibility of inducing a pathergic response 53 . Other dermatological conditions in which Apligraf ® has been applied and led to successful wound healing include hydroxyurea‐induced leg ulcers, bullous morphoea ulcers and ulcerative sarcoidosis 54–56 …”

Section: Clinical Applicationsmentioning

confidence: 99%

The role of fibroblasts in tissue engineering and regeneration

2007

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Fibroblasts are mesenchymal cells that can be readily cultured in the laboratory and play a significant role in epithelial-mesenchymal interactions, secreting various growth factors and cytokines that have a direct effect on epidermal proliferation, differentiation and formation of extracellular matrix. They have been incorporated into various tissue-engineered products such as Dermagraft (Advanced BioHealing, La Jolla, CA, U.S.A.) and Apligraf (Novartis, Basel, Switzerland) and used for a variety of clinical applications, including the treatment of burns, chronic venous ulcers and several other clinical applications in dermatology and plastic surgery. In this article we review the cell biology of dermal fibroblasts and discuss past and current experience of the clinical use of cultured fibroblasts.

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“…Leg ulcers caused by hydroxyurea often have a poor response to standard ulcer therapeutic agents 15 . Flores et al 16 report a 74‐year‐old woman with a history of chronic myelocytic leukemia (CML) who developed a malleolus ulcer while on hydroxyurea. Graftskin was sutured into the wound bed, and healing was complete 3 weeks later.…”

Section: Discussionmentioning

confidence: 99%