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Risk factors associated with high-risk patients with PV: An update from IACH 2024

By Dylan Barrett

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Oct 24, 2024

Learning objective: After reading this article, learners will be able to cite a new clinical development in polycythemia vera.



During the 7th Annual Meeting of the IACH, Alvarez-Larrán discussed factors that should be considered in the risk stratification of patients with PV.1 Risk factors associated with the complications of high-risk PV, such as arterial/venous thrombosis, increased bleeding, and disease progression, were also discussed.1


Key learnings
High-risk patients with PV are stratified based on age >60 years, a history of arterial/venous thrombosis, persistent leukocytosis, and inadequate hematocrit control with phlebotomies. 
Risk factors associated with arterial thrombosis include the history of arterial thrombosis, age >60 years, cardiovascular risk factors, and TET2/DNMT3A mutations. Risk factors related to venous thrombosis include JAK2V617F VAF >50% and an NLR >5.
Extreme thrombocytosis and AVWD (VMF <30%) are associated with increased bleeding. 
JAK2V617F VAF >50%, TP53 mutations, and chromatin/spliceosome mutations have been linked with disease progression to MF or AML. 
A personalized approach that considers individual risk factors may be needed in the stratification and management of patients with high-risk PV. 

Abbreviations: AML, acute myeloid leukemia; AVWD, acquired von Willebrand disease; IACH, International Academy for Clinical Hematology; MF, myelofibrosis; VAF, variant allele frequency; VMF, von Willebrand factor; WBC, white blood cell. 

References

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