Haemolytic anemia in a patient of chronic myeloid leukemia: an unrecognized side-effect of hydroxyurea?

Abstract

Hydroxyurea (HU) is frequently used in the treatment of various myeloproliferative neoplasms (MPN)
where it reduces cell proliferation by impairing DNA synthesis leading to decreased hematopoiesis.
Herein we report a case of a 65-year-old female who was diagnosed with Chronic myeloid leukemia and
developed severe hemolytic anemia requiring multiple packed red blood cell (RBC) transfusions while
being treated with hydroxyurea. The haemolysis persisted until discontinuation of the drug. Common
side-effects of HU like macrocytic anemia, leucopenia, and thrombocytopenia are well known but
hemolytic anemia is a rare side-effect, not well known with only a handful of cases being described in the
scientific literature so far.