What’s the Magic Number? Managing Hematocrit Levels in MPNs

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Topics include: Understanding

Dr. David Snyder from City of Hope and Dr. Bart Scott from Seattle Cancer Care Alliance discuss hematocrit levels related to polycythemia vera (PV).  Both experts share their perspective about what the ideal hematocrit level is and why.

This event was produced in association with City of Hope and sponsored by Patient Empowerment Network through educational grants from Incyte Corporation and Geron Corporation.

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Transcript

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Danny:

My wife has PV, and a number of times today you doctors have mentioned a number of her hematocrit at being under 45 percent. But, I think once or twice, oh, there you go, Dr. Snyder said, for women it’s less. And we’ve been under the impression it should be under 43 for her and haven’t found a consensus with doctors. So I wanted to know what are your thoughts?

Dr. Scott:

So, the CYTO-PV study that I mentioned earlier was a randomized trial that compared less than 45 to essentially greater than 45. That enrolled both women and men, and that is one of the randomized trials that showed a benefit to keeping the hematocrit to less than 45.

As far as I know, they didn’t do a subgroup analysis specifically based on gender. Historically, before the CYTO-PV trial, what people would say is that for men less than 45 and for women less than 42. There probably is not a consensus of opinion of what the goal hematocrit is for women.

But I like to base my clinical judgments on Phase III randomized trial when we can because I consider that to be the gold standard of medical evidence. So, for me, my practice is to have a baseline hematocrit of 45 for both women and men.

But if other people wanted to say that they like to keep women less than 42, I wouldn’t necessarily argue against that practice.

Dr. Snyder:

I’m in that latter camp. I do use 42 percent in general for my female patients. But I have to say I have some patients where it’s even lower. I think Mike mentioned that he used to know when it was time for a phlebotomy. I have some patients who get to 41 percent, a man, who gets a constellation of symptoms. His thinking gets fuzzy. His vision’s a little off. He has a headache. And, so, we use 41 percent as the trigger for him. So there’s variation there.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Page last updated on October 7, 2014