Oncology Brothers: Practice-Changing Cancer Discussions Myeloproliferative Neoplasms (MPN) Treatment: Polycythema Vera (PV) & Essential Thrombocythemia (ET)
Aug 4, 2025
Dr. Andrew Kuykendall, a hematologist from Moffitt Cancer Center, brings his expertise in myeloproliferative neoplasms to a discussion centered on polycythemia vera (PV) and essential thrombocythemia (ET). Key topics include the vital role of JAK2 mutation testing in diagnosis and the latest treatments like ruxolitinib and resveratide. Dr. Kuykendall also emphasizes risk stratification for ET and the importance of managing acquired von Willebrand disease in patients with high platelet counts, showcasing a new era in personalized cancer care.
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Workup: EPO Then JAK2 Then Biopsy
- Check EPO first and reflex to JAK2 testing when EPO is low to streamline PV workup.
- Reserve bone marrow biopsy until JAK2 is positive unless a secondary cause is strongly suspected.
SGLT2 Inhibitors Cause Erythrocytosis
- SGLT2 inhibitors are an increasingly common cause of secondary erythrocytosis.
- Always review medications and history of lung or cardiac disease when evaluating high hematocrit.
Risk Stratify PV By Age And Thrombosis
- Use age >60 or prior thrombotic event to define high-risk PV and add cytoreductive therapy.
- Continue aspirin and phlebotomy to maintain hematocrit <45% for all patients.