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When do you utilize cytoreductive therapies in the treatment of PV?

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When I make a diagnosis of polycythemia in a patient, and if they happen to be high risk individual that is greater than sixty years of age or have had the thrombotic event or potentially have other risk factors like heart disease, diabetes, etc., then I would like to initiate cytoreductive therapy. Once you start the treatment, obviously you have to monitor the blood count of the patient on a periodic basis. Meanwhile, you're trying to optimize the hematocrit by phlebotomy.

Once I know that we've already determined the dose that they're going to be taking, then the follow up becomes less frequent.

Compliance is always something that we have to evaluate. It's an issue, and I think if you sort of have an open dialogue with your patient, I still think that compliance is probably one of the hardest things to truly assess when it comes to patients.

Image of Jamile M Shammo, MD, FASCP, FACP
Jamile M Shammo, MD, FASCP, FACP Associate Professor Rush University Medical Center | Chicago, IL
As principal investigator of clinical trials in her area of expertise, Dr Shammo is heavily involved in education, research, and administrative activities in the Division of Hematology/Oncology. She is recognized nationally for her expertise in bone marrow failure syndromes/paroxysmal nocturnal hemoglobinuria (PNH) and was chosen to serve as a national coordinator for the US PNH registry.