Dr. Sormann Siegfried
Anagrelide, a quinazoline derivative, was initially developed as a platelet function inhibitor and then noted to be a relatively selective thrombocytopenic agent . The mechanism by which anagrelide reduces platelet count is not yet clear, although the current hypothesis is that anagrelide affects the late (postmitotic) phases of megakaryocyte development.
The recommended starting dose of anagrelide is 0.5 mg four times a day or 1 mg twice a day, with dose adjustment to the lowest effective amount (usual maximum daily dose of 4 mg/day) required to reduce and maintain the platelet count to less than 600,000/microL. Adverse effects of this agent include fluid retention, vasodilation with renal insufficiency, and frank heart failure.
anagrelide therapy is associated with increased risk for arterial thrombosis, bleeding, and MF transformation, but less venous thrombosis than HC therapy
more than a quarter of patients receiving anagrelide therapy become anemic while a lesser percentage experience renal insufﬁciency and cardiac complications including arrhythmia and cardiomyopathy