A paradigm shift in the treatment of patients with polycythemia vera. The initial early use of recombinant interferon-alpha - PubMed
3 hours ago
- #treatment paradigm
- #interferon-alpha
- #polycythemia vera
- Recombinant interferon-alpha (rIFNα) shows efficacy and safety in treating polycythemia vera (PV), leading to symptom relief, splenomegaly regression, blood count normalization, and molecular remission after 2-5 years of treatment.
- Clinical trials like PROUD-CONTI and Low-PV established the superiority of rIFNα (specifically ropeginterferon alpha-2b) over hydroxyurea and phlebotomy-only, leading to regulatory approvals for both high-risk and low-risk PV patients.
- Despite evidence, hydroxyurea remains widely used, and some hematologists still endorse phlebotomy as maintenance therapy, though it may increase thrombotic risk and contribute to myelofibrosis progression.
- Guidelines from organizations like NCCN and ELN recommend rIFNα for low and high-risk PV, especially in low-risk patients with issues like symptoms, splenomegaly, leukocytosis, or inadequate hematocrit control after phlebotomy.
- The authors advocate for initial treatment with rIFNα in all PV patients unless contraindicated, citing benefits in reducing thrombotic risk and preventing disease progression compared to traditional therapies.