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What are some of the issues in the management of PV?

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I mean I think anytime you meet a patient who has any given disease and specifically PV, you'd like to talk to the patient, figure out their symptoms, make a treatment plan, discuss treatment options, assess disease burden, obviously so they can help you choose a treatment at the time and then also decide how you want to monitor the patient for efficacy of the treatment that you've already proposed.

When I have a patient who has PV I always think of managing them in terms of a triad. We have to tackle the blood counts—make sure that they are optimized, make sure that they are not having symptoms related to spleen and constitutional symptoms that might come with that, and then finally make sure that we prevent thrombotic events.

There are a lot of issues that oncologists have to think about when optimizing care of their patients who have PV; for example, they need to make sure that the counts are taken care of, they’re optimized, and hematocrit is well controlled. That their patients are tolerating treatment as prescribed, and that they are also managing some of the additional cardiac risk factors and the diabetes, and the high blood pressure which could also add to morbidity and mortality. So this I think is where not just a hematologist but also a primary care physician could put in their weight and hopefully optimize the care of the patient.

Also perhaps monitor the spleen size, monitor some of the symptoms that patients are having relative to constitutional symptoms and weight loss and night sweats, etc.

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.