Published recently inEuropean Oncology & Haematology Review, the peer-reviewed journal from touchONCOLOGY, Jean-Jacques Kiladjian et al, present a review of polycythaemia vera (PV), an uncommon chronic myeloproliferative neoplasm characterised by increased red-cell mass. The condition is currently managed by phlebotomy and/or palliative cytoreductive therapy, most commonly using hydroxyurea (HU). However, around 25% of patients have an inadequate response and/or unacceptable adverse effects; furthermore, patients with resistance to HU appear to have shorter survival than other patients with PV. Recently, a second-line treatment has become available. Ruxolitinib, an oral inhibitor of the Janus kinase (JAK) 1 and JAK 2 tyrosine kinases, has recently received regulatory approval for the treatment of patients with PV who are resistant to or intolerant of HU. This treatment offers the potential to significantly reduce phlebotomy requirements and improve the symptom burden. However, in order to determine which patients will benefit most from ruxolitinib, it is necessary to identify those who are inadequate responders to HU, a definition that is not currently consensual in the literature. Five patient groups, for whom ruxolitinib may be a beneficial second-line treatment option, have been proposed. These comprise patients who are at high risk and retain a high symptom burden after HU, require frequent phlebotomy, have an elevated leukocyte count, are intolerant to HU or interferon, or have palpable splenomegaly.
The full peer-reviewed, open-access article is available here:
Disclosure: Jean-Jaques Kiladjian has received institutional research funding from Novartis and AOP Orphan and particpated on advisory boards for Novartis, Shire and AOP Orphan. Yvonne Francis and Juliette Soret have nothing to disclose in relation to this article. This study involves a review of the literature and did not involve any studies with human or animal subjects performed by any of the authors.
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European Oncology & Haematology Review, a peer-reviewed, open access, bi-annual journal specialising in the publication of balanced and comprehensive review articles written by leading authorities to address the most important and salient developments in the field of oncology and haematology. The aim of these reviews is to break down the high science from 'data-rich' primary papers and provide practical advice and opinion on how this information can help physicians in the day to day clinical setting. Practice guidelines, symposium write-ups, case reports, and original research articles are also featured to promote discussion and learning amongst physicians, clinicians, researchers and related healthcare professionals.