Version:
1.0
Review date:
May 2026
Adapted from:
RDTC shared care protocol version 1.1 (October 2023, updated March 2024)
Replaces:
GMMMG Shared Care Protocols for Hydroxycarbamide in adult sickle cell disease and adult myeloproliferative disease (17/8/2017, Version 2.1)
Local approval date:
22.02.2024 (local content added)
CRG approval date:
09.04.2024
GMMMG approval date:
09.05.2024
CEGC approval date:
23.05.2024
Intended users:
NHS healthcare professionals
Target population:
Adults aged 18 and over with myeloproliferative disorders or sickle cell disease
Licensed indications:
Chronic myeloid leukaemia; Essential thrombocythaemia; Polycythaemia vera; Sickle-cell disease
Off-label indications:
Primary myelofibrosis; Unclassified myeloproliferative disorders; Psoriasis
Treatment setting:
Shared care between specialist and primary care (transfer after ≥12 weeks when stable)
Initiation responsibility:
Specialist
Prescribing transfer:
Primary care after stabilisation and satisfactory results
Dose range (initial):
Essential thrombocythaemia 15 mg/kg daily; Polycythaemia vera 15–20 mg/kg daily; Sickle-cell disease 15 mg/kg daily with 5 mg/kg steps
Maintenance dose range (sickle-cell disease):
15–30 mg/kg daily (max 35 mg/kg)
Dose adjustment considerations:
Elderly, renal impairment (CrCl ≤60 mL/min start reduced by 50%), myelotoxicity
Baseline investigations:
FBC, U&Es/eGFR or CrCl, LFTs, viral screening, lung disease screening (clinician discretion), vaccination status
Additional sickle-cell baseline:
Reticulocyte count
Monitoring frequency (primary care):
Every 8–12 weeks (FBC, U&Es, LFTs, reticulocyte count for sickle-cell disease)
Ongoing specialist monitoring:
Usually annually; specialist retains responsibility for treatment response and dose changes
Vaccination note:
Shingles vaccine eligibility for ages 50–79 (refer to Green Book)
Shared care protocol type:
Clinical prescribing and monitoring guideline
