Optimal Therapy for Polycythemia Vera and Essential Thromboc
Recent articles have obscured the value of recombinant interferon-alpha (rIFN?) in polycytemia vera (PV) and essential thrombocythemia (ET) either as initial therapy instead of phlebotomy, or because the value of rIFN? has not been established on the basis of phase 3 trials. For high risk PV or ET patients, it is suggested that rIFN? use be limited pending the results of a randomized trial comparing the response of rIFN? to hydroxyl urea (HU). Concern is also expressed because of the growing popularity of once weekly pegylated interferon-alfa (PEG-rIFN?) for treating PV and ET “offlabel” without the results of this slowly accruing phase 3 trial. For “low risk” PV patients (less than 60 years of age and no prior history of thrombosis), we are apprehensive about the recommendation of phlebotomy-only (Ph-O) as definitive treatment ...