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Prognostic factors used to guide therapy selection in PV

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There are two types or two ways of risk stratification. The classic one to guide treatment and a more comprehensive one to predict outcome. One is basically to decide on treatment, and this is the classical way that we've used for P vera and for essential thrombocythemia. So, we divide the patients into two risk groups: those that are at increased risk of developing thrombosis and that include patients above age of 60, and those that had history of thrombosis, whether arterial or venous. So, those are coded with the high-risk group compared to a low risk—lower-risk group that are below age of 60 and never had an event.

Obviously, this is a good starting point but it does have some limitations. Yes, patients above age of 60 do have increased risk of thrombosis but events do occur in younger patients. Now, the type of events may be different, younger patients may be getting more DVT or PE while older patients sometimes tend to get more arterial events. But younger patients are not immune from getting thrombotic events. We know now that there are other factors that may contribute to increased risk of thrombosis such as the leukocyte count, the platelet count.

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Rami S Komrokji, MD Clinical Director of the Malignant Hematology Department Moffitt Cancer Center | Tampa, FL
Dr Rami Komrokji is a senior member of the Malignant Hematology and Experimental Therapeutics Program at the Moffitt Cancer Center and is a professor in medicine and oncologic sciences at the University of South Florida’s College of Medicine. Dr Komrokji has authored or co-authored more than 80 peer-reviewed manuscripts, 20 book chapters, and more than 200 abstracts on hematologic malignancies and is a peer reviewer for such medical journals as Blood, Journal of Clinical Oncology, and Leukemia. Dr Komrokji serves as a member on the MDS Panel of the National Comprehensive Cancer Network® (NCCN®).