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PubMedDate not supplied

Randomized phase II trial of either fluorouracil, parenteral hydroxyurea, interferon-alpha-2a, and filgrastim or doxorubicin/docetaxel in patients with advanced gastric cancer with quality-of-life assessment: eastern cooperative oncology group study E6296.

PURPOSE: The Eastern Cooperative Oncology Group conducted a randomized phase II trial to determine the objective response rates, toxicities, and overall survival and to assess effects on quality of life for two combination regimens in patients with advanced gastric cancer. PATIENTS AND METHODS: All patients had biopsy-proven, untreated metastatic gastric cancer with measurable disease. The FHIG arm employed infusional fluorouracil (F), 2.6 g/m2, given intravenously over 24 hours once perweek for 6 weeks; infusional hydroxyurea (H), 4.3 g/m2, given intravenously over 24 hours once per week for 6 weeks; and interferon-alpha-2a (1), 9 MU given subcutaneously three times per week, once per week for 6 weeks. The AD arm employed doxorubicin (A), 50 mg/m2, and docetaxel (D), 75 mg/m2, both given intravenously every 21 days. Quality of life was measured by the FACT-Fatigue scale and a novel questionnaire assessing interferon-mediated fatigue. RESULTS: Twenty-nine patients were enrolled; 23 were eligible and evaluable. Twelve were enrolled on FHIG and 11 on AD. The major grade > or = 3 toxicities were neuromotor (46%) in patients receiving FHIG and granulocytopenia (91%) in those receiving AD. There were two fatalities in the AD arm. There was one partial responder on FHIG (8.3%) and none on AD. The median survival was 6.6 months for FHIG and 10.1 months for AD. Quality-of-life analysis did not show substantial cumulative fatigue in patients treated with FHIG. CONCLUSIONS: Neither regimen demonstrated enough activity to serve as a platform for the development of further clinical regimens against gastric carcinoma. A subset of patients receiving interferon was able to tolerate therapy without deterioration in quality of life.

Adult↗

PubMed2005

Hematologic and clinical responses of thalassemia intermedia patients to hydroxyurea during 6 years of therapy in Iran.

Hydroxyurea (HU) is a well-known chemotherapeutic agent that has been used largely for the treatment of various myeloproliferative conditions over the past 20 years. In beta-thalassemia, the role for HU is much less clear and remains controversial. This study was undertaken to describe the hematologic and clinical responses of thalassemia intermedia patients to HU treatment during 6 years in Southern Iran. One hundred sixty-three thalassemia intermedia patients were selected among the 3,000 cases of beta-thalassemia in Southern Iran from 1998 to 2003. All patients underwent laboratory tests and quantitative hemoglobin electrophoresis. Group 1 comprised patients receiving regular blood transfusions (after age 2 years old). Group 2 comprised those without any history of blood transfusions suffering from chronic anemia or long-interval transfusions. The state of energy, fatigability, and mood were recorded before the trial. Facial change was compared before and after treatment with HU. Electrocardiogram and echocardiography were carried out before and during treatment with HU. All patients were treated with HU; the starting dose was 8 to 12 mg/kg/d given orally once a day. Of the 163 patients, 149 tolerated the HU well and showed a dramatic response to the drug. Eighty-three of 106 transfusion-dependent patients (group 1) became completely transfusion-free, and 23 had one or two transfusions throughout the study. Sixteen of 43 patients (group 2) who were on long-interval transfusions became transfusion-free and 27 group 2 patients were transfusion-free, with developing acceptable hemoglobin levels. After treatment, 97% of patients described an increase in exercise tolerance, and no significant facial change was observed after therapy. No change in spleen size was observed in 83% of the patients. HU therapy was also associated with a marked increase in hemoglobin, mean corpuscular volume, and mean corpuscular hemoglobin. HU may be administered in thalassemia intermedia patients to minimize or even obviate the need for regular transfusions and concomitant iron overload, and HU therapy appears to be safe and effective when administered in thalassemic patients.

Adolescent↗

PubMed1975

Electron microscopic studies on assembly of herpes simplex virus upon removal of hydroxyurea block.

The release of hydroxyurea-treated, herpes simplex virus-infected cells from the drug-induced block resulted in the prompt assembly of infectious virus. Electron microscope observations at sequential intervals following removal of the drug revealed considerable synchrony of replication. This synchrony permitted stages in the complex process of core assembly to be examined in detail. The data suggest that after partial or complete assembly the nucleoprotein enters the differentiated capsid to become enfolded.

Cell Nucleus↗

PubMed1977

Replication of herpes simplex virus DNA after removal of hydroxyurea block from infected cells.

Hydroxyurea (HU) treatment of HSV-infected cells markedly inhibits the synthesis of virus DNA. Only 0-3.6 of the 3H-thymidine label was incorporated into virus DNA in the presence of HU as compared to untreated infected cells. Removal of HU resulted in a renewed synthesis of virus DNA as determined by the gradual increase in the incorporation of 3H-thymidine into HSV DNA. The labelled virus DNA molecules were isolated and chromatographed on benzoylated napthoylated DEAE (BND)-cellulose columns to separate the replicative intermediates that have single-stranded (ss) sequences from the mature double-stranded (ds) DNA genomes. Mature radioactive dsDNA molecules were found to appear at 22 min after removal of HU and gradually increased in amount thereafter. The virus DNA molecules synthesized during the initial 20 min after removal of HU, constitute the replicative intermediates of HSV DNA. It was calculated that the synthesis of HSV DNA proceeds at the rate of about 5 X 10(6) daltons per min.

Animals↗

PubMed2002

Hydroxyurea treatment for sickle cell disease.

High fetal hemoglobin (HbF) levels inhibit the polymerization of sickle hemoglobin (HbS) and reduce the complications of sickle cell disease. Pharmacologic agents that can reverse the switch from gamma- to beta-chain synthesis--gama-globin chains characterize HbF, and sickle beta-globin chains are present in HbS--or selectively increase the proportion of adult erythroid precursors that maintain the ability to produce HbF are therapeutically useful. Hydroxyurea promotes HbF production by perturbing the maturation of erythroid precursors. This treatment increases the total hemoglobin concentration, reduces the vaso-occlusive complications of pain and acute chest syndrome, and attenuates mortality in adults. It is a promising beginning for pharmacologic therapy of sickle cell disease. Still, its effects are inconsistent, trials in infants and children are ongoing, and its ultimate value--and peril--when started early in life are still unknown.

Anemia, Sickle Cell↗

PubMed2020

Distinct roles of BRCA2 in replication fork protection in response to hydroxyurea and DNA interstrand cross-links.

DNA interstrand cross-links (ICLs) are a form of DNA damage that requires the interplay of a number of repair proteins including those of the Fanconi anemia (FA) and the homologous recombination (HR) pathways. Pathogenic variants in the essential gene BRCA2/FANCD1, when monoallelic, predispose to breast and ovarian cancer, and when biallelic, result in a severe subtype of Fanconi anemia. BRCA2 function in the FA pathway is attributed to its role as a mediator of the RAD51 recombinase in HR repair of programmed DNA double-strand breaks (DSB). BRCA2 and RAD51 functions are also required to protect stalled replication forks from nucleolytic degradation during response to hydroxyurea (HU). While RAD51 has been shown to be necessary in the early steps of ICL repair to prevent aberrant nuclease resection, the role of BRCA2 in this process has not been described. Here, based on the analysis of BRCA2 DNA-binding domain (DBD) mutants (c.8488-1G>A and c.8524C>T) discovered in FA patients presenting with atypical FA-like phenotypes, we establish that BRCA2 is necessary for the protection of DNA at ICLs. Cells carrying BRCA2 DBD mutations are sensitive to ICL-inducing agents but resistant to HU treatment consistent with relatively high HR repair in these cells. BRCA2 function at an ICL protects against DNA2-WRN nuclease-helicase complex and not the MRE11 nuclease that is implicated in the resection of HU-induced stalled replication forks. Our results also indicate that unlike the processing at HU-induced stalled forks, the function of the SNF2 translocases (SMARCAL1, ZRANB3, or HLTF), implicated in fork reversal, are not an integral component of the ICL repair, pointing to a different mechanism of fork protection at different DNA lesions.

BRCA2 Protein↗

PubMed1987

Comparison of the inhibitory effects of hydroxyurea, 5-fluorodeoxyuridine, 3,4-dihydroxybenzylamine, and methotrexate on human squamous cell carcinoma.

A cell line (SCC-25) derived from a human squamous cell carcinoma was found to have a higher level of in situ thymidylate synthase activity when compared to a faster-growing cell line, L1210 leukemia, and approximately 5 times the level of activity of a cell line with the same growth rate, S91-A melanoma. These results led to an examination of the effects of both direct and indirect inhibitors of this enzyme using intact SCC-25 cells. It was found that drugs that have an indirect effect on this enzyme--methotrexate (MTX), hydroxyurea (HU), and 3,4-dihydroxybenzylamine (3,4-DHBA)--acted as noncompetitive inhibitors and the inhibition of thymidylate synthase by these drugs did not result in the accumulation of its substrate, dUMP. This suggested that these drugs are also inhibiting steps leading to the formation of dUMP by a mechanism that is coordinated with the inhibition of thymidylate synthase. 5-Fluorodeoxyuridine (FUDR), a competitive inhibitor of thymidylate synthase, did cause an increase in the dUMP pool size indicating that this drug did not affect the synthesis of this substrate. There was a good correlation for the inhibition of growth, DNA synthesis, and thymidylate synthase with HU, 3,4-DHBA, and FUDR. However, the results suggested fundamentally different mechanistic reasons for the close relationship among these three inhibitory effects. Finally the inhibition of growth by MTX did not appear to correlate with the inhibition of DNA synthesis. The implication of these results for the therapy of epidermally derived proliferative disorders, especially with combinations such as MTX and 5-FU, is discussed.

Animals↗

PubMed1980

The effect of methotrexate and hydroxyurea on neutrophil chemotaxis.

Methotrexate depresses motility of neutrophils in chamber membranes, but does not interfere with random motility in tubes. Hydroxyurea has no such effect. The therapeutic response to methotrexate in psoriasis may be due in part to a reduction in migration of neutrophils into the epidermis.

Cell Movement↗

PubMed1989

Keratin gene expression during the resolution of psoriatic plaques: effect of dithranol, PUVA, etretinate and hydroxyurea regimens.

Quantitative changes in the levels of keratin polypeptides extracted from keratotome shavings from psoriatic epidermis were measured by using one-dimensional SDS-PAGE, followed by scanning densitometry. Values obtained were compared with results for non-lesional epidermis and from epidermis from normal individuals. Patients on four different treatment regimens were investigated by repeated sampling over 3-4 months starting before therapy commenced. The levels of four keratins changed significantly: keratins I (70 kd) and 2 (66 kd) tended to rise to normal levels, while keratins 16 (50 kd) and 18 (44 kd) fell to normal levels. There were differential effects as well as differences in the rates of normalization depending upon the treatment regimen. The most rapid normalization of the levels of all four keratins was observed with topical dithranol (anthralin) treatment (five patients) with plaque resolution and keratin level normalization after 7-9 weeks. Oral hydroxyurea (three patients) had similar effects, but over a longer time scale (20 weeks). In contrast, oral etretinate (four patients) caused a normalization of all except keratin 2 (66 kd) over a period of 20-28 weeks, and keratin I (70 kd) levels tended to 'overshoot' the normal level. PUVA (five patients) caused rapid normalization (in 9-12 weeks) of keratins 2 (66 kd) and 18 (44 kd), but had much weaker effects on keratins I (70 kd) and 10 (57 kd). These results suggest that resolution of lesions as judged by clinical criteria can occur without normalization of the keratin electrophoretic profile. Possibly the most reliable marker of clinical resolution was the reduction in keratin 16 (50 kd), since treatment effects on the differentiation of keratins I (70 kd) and 2 (66 kd) were different.

Anthralin↗

PubMed1993

Improvement of mouse beta thalassaemia by hydroxyurea.

The present report provides evidence that hydroxyurea (HU) improves the beta thalassaemic phenotype in mice receiving 200 mg/kg/d for 30 d. The haematocrit rose from 29 +/- 3% at day 0 to 37 +/- 4% at day 30 (P < 0.05), despite myelosuppression and decreased reticulocyte counts. The beta minor/alpha ratio of globin chain synthesis increased from 0.78 at day 0 to 0.97 at day 30 (P < 0.001). Membrane defects improved: the proportion of bound alpha chains decreased, the proportion of spectrin and ankyrin increased and red cell deformability also increased.

Animals↗

PubMed1995

Clinical and laboratory effects of long-term administration of hydroxyurea to patients with sickle-cell/beta-thalassaemia.

Hydroxyurea (HU), a widely used cytostatic, has been given over a long period of time to 14 adult Caucasian compound heterozygotes for beta s and various beta-thalassaemia genes. All patients had severe pain crises and other complications prior to receiving the drug. After 4-8 weeks on high 'sub-toxic' doses of HU all patients responded with a multifold increase of fetal haemoglobin (HbF) and a marked increase of MCV and MCH; they also felt significantly better and ceased having pains or other complaints. Haematological toxicity was minimal and rapidly reversible. Follow-up of the patients has now exceeded 100 weeks and goes up to 180 weeks in two of them. Pain crises have never recurred. Maintenance of high levels of HBF requires continuous administration of high doses of HU; whenever the latter were decrease in various attempts to avoid potential long-term toxicity, the observed changes gradually faded. The effect of HU in HbS/beta-thalassaemia may be better than that reported for homozygous HbS disease because the synthesized gamma-chains not only inhibit the sickling process but they also neutralize the noxious effects of the excess alpha-chains and cut down the ineffective erythropoiesis of the patients.

Adult↗

PubMed2005

Modulation of erythrocyte arginase activity in sickle cell disease patients during hydroxyurea therapy.

An elevated erythrocyte arginase activity with a corresponding decrease in nitric oxide (NO) level has been implicated in the pathophysiology of sickle cell disease (SCD). Recent studies have shown that hydroxyurea (HU) increases the production of NO, which increases the soluble guanylate cyclase activity and fetal haemoglobin (HbF) synthesis. To study the effects of HU on the arginase and nitric oxide synthase (NOS) activities in SCD patients, we compared levels of arginase activity and NO metabolites in red blood cells and plasma, respectively, from 23 patients with SCD (HbSS) receiving HU therapy, with those of 12 SCD patients not receiving HU treatment. Patients on HU therapy showed significantly lower arginase activity than that of HbSS patients not on HU therapy (1.36+/-0.2 U/10(8) cells vs. 3.31+/-0.29 U/10(8) cells). NOS activity was higher in patients on HU therapy than in untreated patients (0.72+/-0.4 nmol/ml/min vs. 0.35+/-0.15 nmol/ml/min, P<0.05). Among the HU-treated patients, the decreased level of arginase activity correlated (r=0.71) with HbF level as well as the mean corpuscular haemoglobin content. These data suggest that one of the beneficial effects of HU in vivo may involve the regulation of arginase activity and a concomitant induction of NOS activity, which may lead to an increased production of NO. The outcome of this study may lead to the development of improved NO-based treatments for SCD.

Adolescent↗

PubMed1975

Matrix simulation of duodenal crypt cell kinetics. II. Cell kinetics following hydroxyurea.

The perturbed cellular kinetics of the duodenal crypt following a single injection of hydroxyurea (HU) have been simulated using matrix algebra. Following the direct effects of HU (S-phase cytotoxicity and a G1/S block) the crypt cell kinetics undergo several alterations. Previously documented alterations include: (1) a temporary partial synchronization of the surviving cells, (2) a shortening of the cell-cycle transit time, and (3) recruitment of normally non-proliferating cells into active proliferation. These conclusions have been extended by constructing several different complex but theoretically possible recovery models and the validity of each of these models has been evaluated by simulating the following biological data: the number of cells in the S and M-phase of the cell cycle, total viable cells per crypt, and the per cent labeled mitosis and the number of labeled cells following 3H-TdR injections at 9 and 21 hr after HU treatment. The model which showed visually the best overall agreement with all sets of the data was chosen as "most probable' and leads to the following interpretations. Immediately after the end of the HU block (i.e. 5 hr after HU injection) the modal cell-cycle transit time is reduced to 8 hr. By 17 hr after HU, the modal transit time is increased to 10 hr. Repopulation of the proliferating compartment, i.e. restoration of the proliferating compartment back to the control value, occurs between 12 and 17 hr after HU injection and probably consists of both recycling of the proliferating cells (i.e. they do not progress up into the non-proliferating compartment) and recruitment of the non-proliferating cells into active proliferation. Also, the rate at which the non-proliferating cells move onto the villi is reduced temporarily. The overall recovery process results in a crypt which temporarily is larger than control and produces villi cells at a rate which is faster than the control. The time when the crypt size and villus cell production rate return to normal cannot be established using the available data.

Animals↗

PubMed1977

The effect of a single injection of hydroxyurea on cell population kinetics in the small bowel mucosa of the rat.

The effect of a single injection of hydroxyurea (HU) on cell population kinetics in the jejunal crypt of the rat was studied using autoradiography with tritiated thymidine and metaphase arrest with vincristine. HU appeared to act selectively on cells in the S phase producing inhibition of DNA synthesis and cell death. The deficit in proliferating cells was made good by a decrease in cell cycle time and an increase in growth fraction. Particular attention was paid to the basal, slowly cycling (and possibly clonogenic) crypt cells; early in the recovery sequence an increase in cell production rate was found in the base of the crypt. It is proposed that basal crypt cells, having survived cycle-specific insult because of long cell cycle times, proceed to repopulated the depleted proliferative compartment.

Animals↗

PubMed1978

Dose-dependent cytokinetic changes following 1-beta-D-arabinofuranosylcytosine and hydroxyurea in L1210 and S-180 in vivo.

DNA synthesis inhibition and recovery in L1210 and S-180 ascites tumors following 1-beta-D-arabinofuranosylcytosine (Ara-C) and hydroxyurea (HU) were measured autoradiographically as a basis for optimizing drug schedules. Tumor bearing mice, 10(6) cells day 0, were treated on day 4 with 20, 200 or 2000 mg/kg Ara-C or 50, 300 or 1800 mg/kg HU. At various intervals following drug, [3H]thymidine was administered i.p. and mice were killed 1 hr later. Tumor cells were analyzed for labeling index (LI) and grain count (GC) to determine the percentage of cells in S phase and the distribution of DNA synthesis rates among the labeled cells, respectively. Following each dose of HU, DNA synthesis was inhibited completely. Recovery of LI was rapid and approached control values by 6 hr. Following each dose of Ara-C, DNA synthesis was inhibited completely for at least 6 hr. Recovery of LI was first noted 6 hr following 20 mg/kg Ara-C and 9 hr following 200 mg/kg. Following both doses the LI reached 100% of the control value by 26 hr. GC analysis indicated that following Ara-C treatment, DNA synthesis was reinitiated first with cells with low GC from 6 to 12 hr followed by cells with increasing GC from 12 to 20 hr. The labeling intensity reached control values by 20 hr and an 'overshoot' occurred by 26 hr. These data suggest that the recovery of DNA synthesis rate is a gradual process. Survival data for mice receiving two doses of Ara-C indicated that the optimal interval for retreatment following the lower dose of Ara-C occurred by 6 hr as compared to 12--16 hr for the higher dose. These times coincided in both instances with recovery of LI to 33--50% of control values. Early recovery of LI may be the best method currently available for estimating the optimal time for retreatment with an S phase specific drug.

Animals↗

PubMed1978

Cell proliferation in EMT6 tumors treated with single doses of x-rays or hydroxyurea. I. Experimental results.

EMT6 mouse mammary tumors were treated in vivo with 5 mg/mouse of hydroxyurea (HU) or 300 rads of X-rays. The proliferation of the tumor cells was followed for 28 hr after treatment. Changes in the 3H-TdR labeling index, the mitotic index, the specific activity of the 3H-TdR-labeled DNA, and the proportion of suspended, clonogenic cells in the S phase of the cell cycle were examined and compared. Evidence was found for reassortment of the surviving cells in treated tumors into partially synchronous cohorts. The partial synchrony in the proliferation of the surviving cells was not accurately predicted by the changes in the labeling index and the mitotic index. The changes in DNA specific activity proved unacceptable as an indicator of cell proliferation in solid EMT6 tumors treated with low doses of radiation or HU.

Animals↗

PubMed1979

Differential lethal effects of both cytosine arabinoside and hydroxyurea on jejunal crypt cells and testosterone-stimulated accessory sex glands.

DNA-synthesizing cells from mouse jejunal crypts and accessory sex glands respond differently to the DNA synthesis inhibitors cytosine arabinoside and hydroxyurea. A single injection of either agent brought about a rapid inhibition of thymidine labelling in both the tissues. Whilst both agents had a lethal effect upon the majority of S-phase cells in the crypts, only a minority of S-phase cells in the accessory sex glands showed evidence of necrosis. These differences are considered in the context of possible physiological differences between continually dividing cells and putative G0 cells. The accessory sex glands are normally quiescent proliferative tissues. They were stimulated to undergo DNA synthesis and later mitosis by testosterone propionate injections, commencing three days after castration. Cytosine arabinoside was the more effective cytocidal agent in the accessory sex glands, and when two injections were scheduled so as to affect a large number of DNA-synthesizing cells, a compensatory hyperplasia was evoked. In the coagulating gland, this compensatory response involved the proliferation of many cells which, in the absence of cytotoxic perturbation, would be non-proliferatie (Q cells).

Animals↗

PubMed1980

Cell proliferation in EMT6 tumours treated with single doses of X-rays or hydroxyurea. II. Computer simulations.

A computer simulation technique was used to analyse data on the proliferation of clonogenic cells in EMT6 tumours treated with 5 mg/mouse of hydroxyurea (HU) or 3.0 Gy (300 rads) X-rays. This simulation technique is able to determine the respective roles of selective killing, blocks in cell progression and recruitment of the treated population. When the technique was applied to tumours treated with HU, it was possible to prove that both a G1/S block and recruitment occurred. These phenomena could not have been demonstrated quantitatively, or even qualitatively, without the use of the simulation. After irradiation, blocks in cell progression and differences in the proliferative patterns of the surviving clonogenic cells and the total tumour cell population were found.

Animals↗