At our recent event Answers Now: Living with Polycythemia Vera (PV), hosted by patient advocate Nick Napolitano and Jun Choi, MD, Hematologist-Oncologist at NYU Langone Health, attendees submitted questions. We asked Angela Fleischman, MD, PhD, Assistant Professor in the Department of Medicine, Division of Hematology/Oncology at UC Irvine Health in Irvine, California, to provide expert answers.
Dr. Fleischman: Other than routine blood counts, no.
Question: How common is cellulitis on the legs from Hydrea [hydroxyurea]? Will antibiotics prevent it from returning? Thank you.
Dr. Fleischman: Hydrea can cause leg ulcers as a rare side effect but not necessarily cellulitis.
Question: Do all PV patients have elevated platelet counts?
Dr. Fleischman: No, not all PV patients have elevated platelet counts.
Question: It’s my understanding that PV can be cured with a bone marrow transplant. Why is this procedure not commonly used?
Dr. Fleischman: Bone marrow transplant is a high-risk procedure and is only done when the risks of dying from the disease are greater than the risks of dying from the transplant. Many times, the risk of transplant is greater than the risk of the disease itself.
Dr. Fleischman: Yes, in most cases it does.
Question: Does PV continue to progress, or can it be maintained at the same level for many years?
Dr. Fleischman: It depends on the person. Some people can maintain steady for many years.
Question: Currently taking hydroxyurea, which keeps my hematocrit within range but makes my white and red blood cell count low. MCV and MCH is high. Is that normal?
Dr. Fleischman: Yes, Hydrea decreases WBC and red blood cells. Also, a well-known side effect of Hydrea is a high MCV [mean corpuscular volume].
Question: Many patients are talking about Besremi [ropeginterferon alfa-2b] as if it’s the new wonder drug. Is it a drug we should all be switching to?
Dr. Fleischman: It is interferon-alpha, which has been available in different formulations for many years. Besremi is a different formulation such that it is long-acting. Interferon is the only medication in MPN that can lead to molecular remissions in some patients.
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