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What Are Common Complications of Polycythemia Vera (PV)?

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Published on April 5, 2016

What are the most common complications for patients with polycythemia vera (PV)?  In this Ask the Expert segment, Andrew Schorr asks Dr. Naval Daver to define and describe these complications.  Hear Dr. Daver discuss thrombosis, symptom decline and the possibility of progression to myelofibrosis (MF).

The Ask the Expert series is sponsored through an educational grant to the Patient Empowerment Network from Incyte Corporation.

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Transcript | What Are Common Complications of Polycythemia Vera (PV)?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.           

Andrew Schorr:

Dr. Daver, I know this is a question you get a lot.  What are the most common complications of PV? 

Dr. Daver:             

Sure.  Yes, this is a question we get a lot in clinic.  So the three main complications we see with PV: one is thrombosis or blood clots.  And that by far is the most common complication that we see in uncontrolled PV or uncontrolled polycythemia vera. 

And most of our strategies, including phlebotomy, aspirin, hydroxyurea (Hydrea), are targeted to reduce the hematocrit with the primary intent of reducing blood clots and thrombosis.  And these thrombosis are unlike other thrombosis in other diseases where they’re usually in the veins.  In PV, they’re not always in the veins; they can be in the arteries.  So we’ve seen people come in with coronary artery disease or heart attacks, strokes, abdominal artery thrombosis, and these can be very life threatening.

So the number one complication, the number one cause of morbidity and mortality or death in PV is actually thrombosis.  And that’s really what we want to reduce with a lot of our treatment.  The second one that we see most commonly is symptoms and quality-of-life decline.  So, because of the high cytokine burden in most myelofibrosis diseases, PV, ET, MF patients will have night sweats, fevers, weight loss, abdominal distension, pain and a lot of people are in the advanced stages not able to work, so there’s a loss of employment, economy.

So that’s usually second.  And then the third one, which a lot of people think is the most concerning, a lot of patients become most concerned about, and it is something important to consider, but it is really third on the list in the order of incidence, is progression of PV to myelofibrosis or MF.  So only about 2 to 3 percent of patients over a 15, 20-year follow-up who have PV will actually progress to acute myeloid leukemia so a very small subset.

We don’t yet have biomarkers to identify that 2 to 3 percent.  But we follow patients closely. And if it happens, we do have things to treat it.  But I think it’s very important to realize that leukemia is just a small subset of the other complications, which need to be addressed.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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