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What would you say is the most common mistake in the management of polycythemia vera (PV)?

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The mistake I see over and over again is that these patients are not being managed close enough when they first get diagnosed with PV. Look for treatment effectiveness of the hydroxyurea dose, especially and frequently in that early phase, in that first 6 months when you’re trying to get patients to a steady-state level of hydroxyurea and control. What I see all too often is that these patients get diagnosed, they start Hydrea® (hydroxyurea) but they don’t get follow-up for 3 to 6 months and their hematocrit is still uncontrolled, you know, like 50. My advice would be that early PV management is very important, so institute phlebotomies immediately if needed to bring their hematocrit below 45—and it could be very frequent initially. And then frequent check of their CBC the first 6 months; check their CBC every 4 weeks, probably until they’re at a steady-state target hematocrit, and then you can bring down the frequency of follow-up.

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Kim-Hien Dao, DO, PhD Assistant Professor of Medicine Knight Cancer Institute, Center for Hematologic Malignancies Oregon Health & Science University | Portland, OR
Dr Kim-Hien Dao serves as the Myelodysplastic Syndromes (MDS)–Myeloproliferative Neoplasms (MPN) Disease Group Leader at the Center for Hematologic Malignancies at Oregon Health & Science University. She is a member of the American Society of Hematology and Myeloproliferative Disorders (MPD) Research Consortium and is active in clinical research trials in MDS and MPNs. Dr Dao has an NIH-funded basic research program focusing on marrow failure in Fanconi anemia, myelodysplasia, and MPNs.