Polycythemia Vera (PV) is a deadly form of blood cancer that occurs when a mutated gene causes bone marrow to create extra red blood cells. The additional cells cause the blood to thicken, slowing its movement through veins and increasing the risk of blood clots. Patients over the age of 60 are at the highest risk for death related to PV. Standard treatments for this condition are phlebotomies and cytoreductive therapy with the drug hydroxyurea. Hydroxyurea (HU) is the more commonly used therapy, but both solutions are often underutilized in PV patients, according to the Yale School of Medicine.
Investigators at Yale recently performed a study of high-risk PV patients and their treatment methods to determine the best course of action for improving life expectancy. The high-risk PV patients involved were 66 years or older, with the median age being 77. Investigators searched patients records for evidence of thrombotic events, as well as treatments used in the past.
Of the 820 patients in the study, those who received phlebotomies had a 35% reduction in death and a 48% reduction in the risk of developing blood clots. When patients also received HU, researchers found that patients who used the medication longer had a lower risk of death.
Phlebotomies are used as a therapeutic “bloodletting” process for PV patients to reduce the amount of blood in their body while HU is used to suppress the bone marrow’s ability to produce excess red blood cells. The study found that a combination of the phlebotomies and HU saved lives, but it also showed that most patients were not receiving these recommended treatments. Analysis showed that almost 40 percent of PV patients were under-treated, receiving neither the recommended treatment nor just phlebotomies. Researchers in the study hope that their results will raise awareness of the two treatment options available for PV patients and the improved outcomes when both are used.