Management of Advanced Polycythemia Vera in a 67-year-Old Man

Dr. Kuykendall discusses his initial impressions of the case, how it compares to typical advanced polycythemia vera presentations, and typical risk factors seen in PV patients.

Dr. Kuykendall explains the factors he considers when deciding on initial therapy for advanced PV patients, including comorbidities, individual patient factors like age and symptoms, and weighing the risks and benefits of different treatment options.

Dr. Kuykendall comments on the high rates of hematocrit control and spleen response with ruxolitinib vs standard therapy in the RESPONSE trial for hydroxyurea-resistant/intolerant PV, and how these efficacy findings inform his treatment choices.

Dr. Kuykendall discusses the efficacy and safety findings from studies like MAJIC-PV and PROUD-PV, and how they influence his treatment choices for PV.

Dr. Kuykendall shares his experience using peginterferon or ropeginterferon for PV treatment, including the biggest challenges, limitations, and managing safety/tolerability issues with these agents.

Dr. Kuykendall explains how he monitors PV patients for thrombosis risk, which hematological values concern him most, and his approach if hematocrit rises above 45%.

Dr. Kuykendall discusses the important quality of life aspects to consider when treating PV patients and the specific strategies or treatments he uses to help preserve overall QoL throughout the disease course.

Dr. Kuykendall provides his perspective on the biggest unmet needs with current advanced PV therapies, emerging data he is following that may impact future management, and any other clinical pearls for optimal PV management.