Monitoring Thrombosis Risk in PV
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%.
Case: Management of Advanced Polycythemia Vera in a 67-Year-Old-Male
Clinical Presentation:
- 67-year-old male presented with frequent headache and dizziness
- Prior medical history is notable for smoking.
- PMH: unremarkable, no splenomegaly
Initial Clinical Workup and Diagnosis:
- Labs:
- Hemoglobin, 20.5 g/dL
- White blood cell count, 13 K/L
- Platelet count, 380 K/L
- Hematocrit, 68%
- JAK2-V617F mutation- variant allele frequency of 65%
- Bone marrow biopsy: trilineage proliferation and pleiomorphic megakaryocytes
- The patient started phlebotomy, aspirin, and Hydroxyurea (HU)
Initial Treatments:
- The patient started phlebotomy, aspirin and HU.
- Over the next year the patient underwent several phlebotomies and remained on aspirin and 2000 mg/day of HU
Disease Progression and Subsequent Treatments:
February 2019
- 2 phlebotomies since the last visit 3 months earlier
- He is also experiencing fatigue and night sweats.
- Labs
- Hgb, 15.5 g/dL
- WBC, 13 K/L
- Platelet count, 380 K/L
- Hematocrit, 47%
Related Videos
Related Content
Lachowiez Considers the Use of Tagraxofusp in BPDCN as Bridge to SCT With Peers
March 21st 2024Article
During a Targeted Oncology™ Case-Based Roundtable™ event, Curtis Lachowiez, MD, discussed targeted therapy for blastic plasmacytoid dendritic cell neoplasm and its role in patients who could receive allogeneic stem cell transplant.
Read More
