Polycythemia Vera Management and Challenges in the Community Health Setting

Aaron T. Gerds, Kim Hien Dao

Research output: Contribution to journalReview article

5 Scopus citations

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)
Pages (from-to)179-189
Number of pages11
JournalOncology (Switzerland)
Volume92
Issue number4
DOIs
StatePublished - Apr 1 2017

Keywords

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

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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