Polycythemia Vera: Risk Assessment

Harry P. Erba, MD, PhD: Krisstina, I’d like to turn back to you and have you comment about risk assessment and polycythemia.

Krisstina Gowin, DO: Risk assessment is based primarily on 2 factors with polycythemia vera. No. 1, how old is the patient? Greater than 60 years of age or less than 60 years of age? No. 2, did they have a prior history of a thrombotic event? If they are young and have not had a history of thrombotic events, then they are a low-risk polycythemia vera patient. On the flip side, if they are more advanced age—as I’m aging into the 40s, that advanced age at 60 is hard to state. But as they’re getting older, it’s not a magic cutoff. If they’re 59 years old and they turn 60, that does not mean that, all of a sudden, their thrombotic risk goes up. We have to take that into consideration as we’re treating these patients and look at some of the other factors that we’re thinking about when we’re assessing thrombotic risk.

What are some of those factors? Those are the cardiovascular factors that we would assess as a primary care physician. Do they have underlying diabetes? Underlying coronary artery disease? Hyperlipidemia? Are they obese? Are they a smoker? It’s a personalized approach when you’re assessing polycythemia vera and their thrombotic risk, and it leads to an opportunity for discussion with our patients in regard to these lifestyle measures.

That’s an area of my own personal passion; we’re treating patients. We’re not treating CVCs [central venous catheters] or hematologic profiles. As hematologists, it’s important to be assessing these risk factors, to be assessing lifestyles, and to be addressing them. Not just identifying them but talking about these things.

Transcript Edited for Clarity