Hydroxyurea Resistant Polycythemia Vera

Video

Hydroxyurea Resistant Polycythemia Vera

January 2015

  • A 39-year-old male presents with headache and weight loss
  • He is a 2-pack a day smoker
  • PMH includes type 2 diabetes, moderately controlled on medication; newly-diagnosed hypertension
  • Physical exam: BP, 176/94, otherwise unremarkable
  • Laboratory values:
    • Hb; 233 g/L
    • Hct; 68.9%;
    • Mean corpusc. vol.; 81 fL
    • Leukocytes; 4.4 × 109/L
    • Platelets; 145 × 109/L
  • Bone marrow biopsy;
    • MF-3 fibrosis and megakaryocytic hyperplasia with atypia
    • Normal karyotype
    • JAK2-positive
  • Patient was started on phlebotomy as needed and aspirin

April 2015

  • Patient had 3 phlebotomies in the last 3 months.
  • He reported increasing dizziness, headaches and nausea
  • He was continued on phlebotomy as needed; aspirin was continued
  • Patient was started on Hydroxyurea 1000 mg daily

July 2015

  • Patient comes back 3 months later, he has had 2 phlebotomies
  • Hydroxyurea is increased to 1500 mg

October 2015

  • Patient returns 3 months later with pruritus, still requiring phlebotomy
  • He is started on hydroxyurea 2000 mg daily

January 2016

  • The patient has had 2 phlebotomies since his last visit; he reports abdominal fullness
  • He also has restless legs and is complaining that food tastes funny
  • Spleen is palpable 7 cm below costal margin

Related Videos
Video 3 - "Managing Toxicities and Adverse Reactions in HR+/Her2-Low mBC Therapies"
Video 2 - "EMERALD: Underscoring Key Elacestrant Data + Subgroup Analyses for Informed Therapy Selection"
Video 1 - "A 62-Year-Old Woman with HR+ HER2-low Metastatic Breast Cancer and Lung, Liver, and Bone Metastases and Using Biomarker Testing to Guide Treatment Selection"
John Mascarenhas, MD, an expert on myelofibrosis
John Mascarenhas, MD, an expert on myelofibrosis
John Mascarenhas, MD, an expert on myelofibrosis
John Mascarenhas, MD, an expert on myelofibrosis
Related Content