Pipobroman therapy of polycythemia vera
A Najman, J Stachowiak, Y Parlier, NC Gorin and G Duhamel
Between 1971 and 1981, 74 patients with polycythemia vera were treated with
pipobroman using a high-dose induction, low-dose maintenance regimen.
Complete remission was achieved in 51 of 54 previously untreated patients
(94.4%) and in 17 of 20 patients (85%) previously treated wih radioactive
phosphorus (32 p) and busulfan. The earliest modifications were noted on
day 16, and on the average, blood counts were normal by day 45. Thirty
percent of the patients relapsed, the mean duration of the remission being
17.5 mo. Following recurrence pipobroman was consistently effective in the
same doses but the mean duration of the next remissions was 10 mo.
Transient leukopenia and thrombocytopenia occurred in 8% and 7% of
patients, respectively, during initial phase, and anemia was noted in 3
patients. Macrocytosis was noted in 20% of patients during maintenance
phase. Three cases of acute leukemia and 3 cases of osteomyelosclerosis
were recorded, all occurring in patients who had previously received 32 p
and/or busulfan. No hematologic malignancies were seen among patients
treated with pipobroman alone; follow-up exceeded 6 yr for 20 patients and
the median follow-up period was 3.6 yr. Pipobroman appears safer than other
alkylating agents; it is as effective as 32 p and works more quickly.
Longer follow-up will be required to evaluate the drug's oncogenic
potential, which is still not known.
Volume 59,
Issue 5,
pp. 890-894,
05/01/1982
Copyright © 1982 by The American Society of Hematology
