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Polycythemia vera (PV) is associated with thrombosis, bleeding, and progression to myelofibrosis or leukemia. Decreasing hematocrit levels in PV patients to <50% reduces the risk for bleeding and thrombosis, but whether further reductions provide additional benefit is uncertain.
To study this issue, Italian investigators randomized 365 PV patients to target hematocrits of <45% or 45% to 50% and recorded disease- and treatment-related complications during a mean of 28.9 (±10.9) months. All patients received low-dose aspirin. Treatment for PV in the low-hematocrit group was intensified (phlebotomies increased from a mean of 2.2 to 3.0 per patient during 6 months, and hydroxyurea dose increased from a mean of 763 mg to 806 mg daily). The illust…
