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The most effective first-line treatment for patients with essential thrombocythemia (ET) and polycythemia vera (PV) is unknown. Hydroxyurea (HU) is the most commonly used treatment for high-risk patients. However, over the last decade, reports of hematological and molecular responses in patients treated with pegylated interferon-α (peg-IFN) have renewed enthusiasm for this agent.
In an international, randomized, controlled trial, investigators compared the safety and efficacy of peg-IFN and HU in 168 high-risk patients with ET or PV. High risk was defined as presence of at least one of the following: age >60; thrombosis history; bleeding (ET only); platelet count >1000 x 109/L in PV and >1500 x 109/L in ET; vasomotor symptoms; splenomegaly; …