Conventional interferon-α 2b versus hydroxyurea for newly-diagnosed patients with polycythemia vera in a real world setting: a retrospective study based on 286 patients from a single center

Liu, Dan; Xu, Zefeng; Zhang, Peihong; Qin, Tiejun; Sun, Xiujuan; Qu, Shiqiang; Pan, Lijuan; Ma, Jiao; Cai, Wenyu; Liu, Jinqin; Wang, Huijun; Sun, Qi; Shi, Zhongxun; Huang, Huijun; Huang, Gang; Gale, Robert Peter; Li, Bing; Rampal, Raajit K.; Xiao, Zhijian

doi:10.3324/haematol.2021.280080

Cited by 4 publications

(1 citation statement)

References 15 publications

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“…and G.A.-Z. ); 97 articles were read in full, and ultimately 14 studies 11 , 16 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 met inclusion criteria ( Figure 1 ). The concordance rate between the reviewers was 91%.…”

Section: Resultsmentioning

confidence: 99%

Cytoreductive therapy in younger adults with polycythemia vera: a meta-analysis of safety and outcomes

Chamseddine,

Savenkov,

Rana

et al. 2024

Blood Advances

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Cytoreductive therapy is not routinely recommended for younger patients with polycythemia vera (PV) due to concern that treatment toxicity may outweigh therapeutic benefits. However, no systematic data supports this approach. To support objective risk/benefit assessment of cytoreductive drugs in PV patients younger than 60 (PV<60), this systematic review and meta-analysis was conducted to evaluate toxicity and disease-related complications in PV<60 treated with interferon alfa (rIFNα) or hydroxyurea (HU). A search of PubMed, Scopus, Web of Science and Embase identified 693 unique studies with relevant keywords, of which 14 met inclusion criteria and were selected for analysis. The weighted average age of patients treated with rIFNα was 48 years (n=744 patients, 12 studies) and for HU was 56 years (n=1397, 8 studies). The weighted average duration of treatment for either drug was 4.5 years. Using a Bayesian hierarchical model, the pooled annual rate of discontinuation due to toxicity was 5.2% (n=587, CI 2.2%-8.2%) for patients receiving rIFNα, and 3.6% (n=1097, CI 1%-6.2%) for HU. The average complete hematologic response (CHR) for rIFNα and HU was 62% and 52%, respectively. Patients experienced thrombotic events at a pooled annual rate of 0.79% and 1.26%; sMF at 1.06% and 1.62%; AML at 0.14% and 0.26%; and death at 0.87% and 2.65%, respectively. No treatment-related deaths were reported. With acceptable rates of non-fatal toxicity, cytoreductive treatment, particularly with disease-modifying rIFNα, may benefit PV<60. Future randomized trials prioritizing inclusion of PV<60 are needed to establish a long-term benefit of early cytoreductive treatment in these patients.

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Section: Resultsmentioning

confidence: 99%

Cytoreductive therapy in younger adults with polycythemia vera: a meta-analysis of safety and outcomes

Chamseddine,

Savenkov,

Rana

et al. 2024

Blood Advances

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Polycythemia vera: aspects of its current diagnosis and initial treatment

Silver

Abu‐Zeinah

2023

Expert Review of Hematology

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Moving toward disease modification in polycythemia vera

Bewersdorf,

How,

Masarova

et al. 2023

Blood

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Polycythemia vera (PV) belongs to the BCR-ABL1-negative myeloproliferative neoplasms and is characterized by activating mutations in JAK2 and clinically presents with erythrocytosis, variable degrees of systemic and vasomotor symptoms, and an increased risk of both thromboembolic events and progression to myelofibrosis and acute myeloid leukemia (AML). Treatment selection is based on a patient's age and a history of thrombosis with low-risk PV patients treated with therapeutic phlebotomy and aspirin alone, while cytoreductive therapy with either hydroxyurea or interferon (IFN)-α is added for high-risk disease. However, other disease features such as significant disease-related symptoms and splenomegaly, concurrent thrombocytosis and leukocytosis, or intolerance of phlebotomy can constitute an indication for cytoreductive therapy in otherwise low-risk patients. Additionally, recent studies demonstrating the safety and efficacy (i.e., reduction in phlebotomy requirements and molecular responses) of ropegylated IFN-α-2b support its use in low-risk PV patients. Additionally, emerging data suggest that early treatment is associated with higher rates of molecular responses, which might eventually enable time-limited therapy. Nonetheless, longer follow-up is needed to assess whether molecular responses associate with clinically meaningful outcome measures such as thrombosis and progression to myelofibrosis or AML. In this review, we provide an overview of the current and evolving treatment landscape of PV and outline our vision for a patient-centered, phlebotomy-free, treatment approach using time-limited, disease-modifying treatment modalities early in the disease course, which could ultimately impact the natural history of the disease.

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Conventional interferon-α 2b versus hydroxyurea for newly-diagnosed patients with polycythemia vera in a real world setting: a retrospective study based on 286 patients from a single center

Abstract: Not available.

Cited by 4 publications

References 15 publications

Cytoreductive therapy in younger adults with polycythemia vera: a meta-analysis of safety and outcomes

Cytoreductive therapy in younger adults with polycythemia vera: a meta-analysis of safety and outcomes

Polycythemia vera: aspects of its current diagnosis and initial treatment

Moving toward disease modification in polycythemia vera

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