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[Radioactive phosphorus (32P); an old but not bad treatment for polycythemia vera]
M E Tesselaar1, P W Wijermans, J A Metsaars
1Afd. Hematologie, Ziekenhuis Leyenburg, Den Haag.
Objective:
To determine if there is a place for radiophosphorus (32P) in the treatment of polycythaemia vera (PV) and essential thrombocytosis (ET).
Design:
Retrospective.
Setting:
Leyenburg Hospital, The Hague, the Netherlands.
Method:
Data on 144 patients with the diagnoses 'PV' or 'ET' from 1965 to 1994 were collected. Available data were insufficient in 19 of these. Regarding 125 patients, 80 with PV and 45 with ET, the survival and the frequency of acute leukaemia with various forms of treatment (32P, busulfan or combination of several treatment modalities) were studied. Moreover, in the PV group the duration of survival was compared with the expected duration of survival in a comparable group of the population.
Results:
Of the 80 PV patients, five developed acute leukaemia: two in the 32P group (5%), two in the busulfan group (12%) and one in the group given combination therapy (4%). Of the 26 patients of the ET group treated with busulfan, one developed acute leukaemia (4%). The survival in the PV group was 4 years shorter than the expected duration of survival in a comparable group of the population.
Conclusion:
Since 32P is efficacious and causes little inconvenience, it should be the drug of first choice in the treatment of PV in the elderly.