Polycythemia Vera Management and Challenges in the Community Health Setting

Aaron T. Gerds, Kim-Hien Dao

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Patients with polycythemia vera (PV) experience shortened survival, increased risk of thromboembolic and hemorrhagic events, and burdensome symptoms. For all patients with PV, treatment with aspirin and hematocrit control with phlebotomy are recommended. In addition, patients with high-risk status or poor hematocrit control benefit from cytoreductive therapy with hydroxyurea, although approximately 1 in 4 patients develops resistance or intolerance. For patients who are resistant to or intolerant of hydroxyurea, studies have shown that ruxolitinib, a Janus kinase 1/2 inhibitor, provides hematocrit control, reduces spleen size, normalizes blood counts, and improves PV-related symptoms. For many patients, PV is managed in a community health setting, and it is important that community hematologists, oncologists, and internists are familiar with the contemporary management of PV to improve patient outcomes, including management for patients who present with unique health-care needs. This review provides an overview of current treatment options for patients with PV and discusses challenging circumstances encountered by community providers in the management of PV, including symptom assessment, identification of hydroxyurea resistance/intolerance, pregnancy, elective surgeries, concomitant immunosuppressants, and managing patients in areas with limited access to specialized hematologic care.

Original languageEnglish (US)
JournalOncology (Switzerland)
DOIs
StateAccepted/In press - Jan 18 2017

Fingerprint

Polycythemia Vera
Health
Hydroxyurea
Hematocrit
Janus Kinase 1
Janus Kinase 2
Phlebotomy
Symptom Assessment
Immunosuppressive Agents
Aspirin
Therapeutics
Spleen
Delivery of Health Care
Pregnancy

Keywords

  • JAK2 inhibitor
  • Janus kinase 2
  • Myeloproliferative neoplasm
  • Polycythemia vera
  • Ruxolitinib

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Polycythemia Vera Management and Challenges in the Community Health Setting. / Gerds, Aaron T.; Dao, Kim-Hien.

In: Oncology (Switzerland), 18.01.2017.

Research output: Contribution to journalArticle

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