ArticleHaematologica2017
Risk of thrombosis according to need of phlebotomies in patients with polycythemia vera treated with hydroxyurea.
Article in Haematologica, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 1 of them a synthesis that pooled it.
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Who cites it
42 citing papers in PubMed, 1 synthesis or guideline pooled it, 72 citations in OpenAlex.
- Hematologic and molecular response to ropeginterferon alfa-2b in patients with polycythemia vera: a systematic review and meta-analysis.Annals of hematology · 2026Pooled it
- Thromboembolic events in polycythemia vera.Annals of hematology · 2019Trial
- Plerixafor enables safe, rapid, efficient mobilization of hematopoietic stem cells in sickle cell disease patients after exchange transfusion.Haematologica · 2018Trial
- Ruxolitinib is effective and safe in Japanese patients with hydroxyurea-resistant or hydroxyurea-intolerant polycythemia vera with splenomegaly.International journal of hematology · 2018Trial
- Risk of thromboembolic events in patients with polycythaemia vera: a study based on german health claims data.Annals of hematology · 2026Article
- Polycythemia Vera and Essential Thrombocythemia: A Nationwide Population-Based Study on Treatment Patterns, Vascular Complications and Survival.European journal of haematology · 2026Article
- Von Willebrand factor and JAK2V617F variant allele frequency predict thrombosis and bleeding in patients with myeloproliferative neoplasms.Annals of hematology · 2025Article
- Old Therapy, New Questions: Rethinking Phlebotomy in a Pharmacologic Landscape.Pharmaceuticals (Basel, Switzerland) · 2025Review
- Impact of ELN clinical signs and symptoms on the thrombotic risk in polycythemia vera patients treated with front-line hydroxyurea.Leukemia · 2025Article
- Exploring thromboembolic risk factors in polycythemia vera: from current evidence to PROSPERO study design.Annals of hematology · 2025Review
- Polycythaemia vera.Nature reviews. Disease primers · 2025Review
- Review
- Impact of Phlebotomy on Quality of Life in Low-Risk Polycythemia Vera.Journal of clinical medicine · 2024Review
- Myeloproliferative Neoplasms: Contemporary Review and Molecular Landscape.International journal of molecular sciences · 2023Review
- Cytoreduction for ET and PV: who, what, when, and how?Hematology. American Society of Hematology. Education Program · 2023Review
- Real-World Clinical Characterisation of Polycythaemia Vera Patients from a Prospective Registry in Portugal: Is Resistance to Hydroxyurea a Reality?Hematology reports · 2023Article
- Cost-effectiveness of ropeginterferon alfa-2b-njft for the treatment of polycythemia vera.Journal of comparative effectiveness research · 2023Article
- Article
- Identifying Patients with Polycythemia Vera at Risk of Thrombosis after Hydroxyurea Initiation: The Polycythemia Vera-Advanced Integrated Models (PV-AIM) Project.Biomedicines · 2023Article
- Prognostication in myeloproliferative neoplasms, including mutational abnormalities.Blood research · 2023Review
Corrections and comments
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Authors and funding
30 authors at 20 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hematocrit control below 45% is associated with a lower rate of thrombosis in polycythemia vera. In patients receiving hydroxyurea, this target can be achieved with hydroxyurea alone or with the combination of hydroxyurea plus phlebotomies. However, the clinical implications of phlebotomy requirement under hydroxyurea therapy are unknown. The aim of this study was to evaluate the need for additional phlebotomies during the first five years of hydroxyurea therapy in 533 patients with polycythemia vera. Patients requiring 3 or more phlebotomies per year (n=85, 16%) showed a worse hematocrit control than those requiring 2 or less phlebotomies per year (n=448, 84%). There were no significant differences between the two study groups regarding leukocyte and platelet counts. Patients requiring 3 or more phlebotomies per year received significantly higher doses of hydroxyurea than the remaining patients. A significant higher rate of thrombosis was found in patients treated with hydroxyurea plus 3 or more phlebotomies per year compared to hydroxyurea with 0-2 phlebotomies per year (20.5% vs. 5.3% at 3 years; P<0.0001). In multivariate analysis, independent risk factors for thrombosis were phlebotomy dependency (HR: 3.3, 95%CI: 1.5-6.9; P=0.002) and thrombosis at diagnosis (HR: 4.7, 95%CI: 2.3-9.8; P<0.0001). The proportion of patients fulfilling the European LeukemiaNet criteria of resistance/intolerance to hydroxyurea was significantly higher in the group requiring 3 or more phlebotomies per year (18.7% vs. 7.1%; P=0.001) mainly due to extrahematologic toxicity. In conclusion, phlebotomy requirement under hydroxyurea therapy identifies a subset of patients with increased proliferation of polycythemia vera and higher risk of thrombosis.
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