Modern and transdisciplinary care in PV: A review

A narrative review of modern and transdisciplinary care for patients with polycythemia vera (PV) was published in Annals of Hematology by Palandri et al. The review explores the goals of PV management and the integrated and transdisciplinary approaches throughout the diagnostic and therapeutic continuum, and proposes a novel cytoreductive treatment algorithm that considers patient characteristics and preferences, treatment toxicity, and disease status beyond conventional age- and thrombosis-based risk factors. Latest insights on PV therapies were also discussed.   

Key findings: The primary goal of PV management is thrombosis prevention. Four management priorities are emphasized: addressing cardiovascular risk factors, low-dose aspirin, maintaining hematocrit <45%, and leukocytes <11 × 10⁹/L. Transdisciplinary care represents a fully integrated, patient-centered approach to PV management, enhancing diagnostic and therapeutic coherence by aligning multidisciplinary expertise with patient needs. The proposed cytoreductive treatment algorithm moves beyond age and thrombotic history, considering patient characteristics/preferences, treatment toxicity, and disease status, with hydroxyurea, ruxolitinib, ropeginterferon alfa-2b, and clinical trials used according to individual need. Research efforts in PV are moving beyond hematocrit and symptom control toward broader disease modification, with clonal suppression through JAK2^V617F variant allele frequency (VAF) reduction emerging as a key target; clinical trials suggest VAF reduction may improve blood counts and lower thrombotic and progression risk. 

Key learning: This review supports a transdisciplinary, patient-centered approach to PV management, emphasizing cytoreductive therapy selection based on disease biology and individual patient needs vs age and thrombotic history alone. Clonal suppression through JAK2^V617F VAF reduction is emerging as a key therapeutic target.