What is the efficacy of maintenance therapies for polycythemia vera (PV)?

Updated: Sep 20, 2021
  • Author: Srikanth Nagalla, MD, MS, FACP; Chief Editor: Sara J Grethlein, MD, FACP  more...
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In an open-label study by Huang and colleagues that included 136 patients with JAK2V617F mutation–positive PV, treatment with interferon alfa 2b (IFN α-2b) did not produce a superior overall hematologic response, compared with HU. However, IFN α-2b provided better 5-year progression-free survival (66.3% versus 46.7%, P< 0.01) and clinical improvement (in vasomotor symptoms, distal paresthesias, and erythromelalgia). No severe hematological adverse events were observed in patients receiving IFN α-2b. [33]

Do not administer alkylating agents to younger patients (< 40 y) who need long-term treatment. Alternative nonleukemogenic agents are needed for these patients

Low-dose aspirin suppresses thromboxane biosynthesis by platelets, which is increased in PV and essential thrombocythemia. The European Collaboration on Low-dose Aspirin in Polycythemia Vera (ECLAP) found that low doses of aspirin (40 mg/d) were effective for preventing thrombosis and controlling microvascular painful symptoms (erythromelalgia), which result from spontaneous platelet aggregation, in patients with PV and essential thrombocythemia, without creating a bleeding diathesis. [34]

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