For US Healthcare Professionals Only
For US Healthcare Professionals Only
For your adult patients on hydroxyurea and phlebotomy
In a subset of patients, these characteristics may indicate advanced PV despite treatment with HU at the maximum tolerated dose and phlebotomy1-4
In my practice, I aim to control all aspects of the blood count: hematocrit less than 45% and white blood cell count less than 11. I wouldn’t necessarily wait until my patient was on 2 grams or 2.5 grams of hydroxyurea a day. For me, that’s a big dose. So, if I cannot increase the dose and they’ve needed 2 or more phlebotomies in the last 6 months, this is the point at which I consider hydroxyurea inadequate and begin to discuss a change in treatment.
Claire Harrison, DM, FRCPath,
MPN Expert
NCCN Guidelines® recommend
Potential indications for change of cytoreductive therapy for patients with symptomatic low-risk PV or high-risk PV are included in the NCCN Guidelines
NCCN Guidelines recommended
Monitor patients for new thrombosis or bleeding, response* to cytoreductive therapy, and signs and symptoms* of disease progression5
Potential indications for change of cytoreductive therapy for patients with symptomatic low-risk PV, or high-risk PV with inadequate response or loss of response5
FDA approved for use in adults with PV after inadequate response to or intolerance of HU6
*Every 3 to 6 months or more frequently as clinically indicated.5
ELN=European LeukemiaNet; Hct=hematocrit; HU=hydroxyurea; MPN=myeloproliferative neoplasm; NCCN=National Comprehensive Cancer Network® (NCCN®); PV=polycythemia vera; RESPONSE=Randomized study of Efficacy and Safety in POlycythemia vera with JAK iNhibitor ruxolitinib verSus bEst available care; WBC=white blood cell.
References: 1. Verstovsek S, Passamonti F, Rambaldi A, et al. A phase 2 study of ruxolitinib, an oral JAK1 and JAK2 inhibitor, in patients with advanced polycythemia vera who are refractory or intolerant to hydroxyurea. Cancer. 2014;120(4):513-520. 2. Marchioli R, Finazzi G, Specchia G, et al; for CYTO-PV Collaborative Group. Cardiovascular events and intensity of treatment in polycythemia vera. N Engl J Med. 2013;368(1):22-33. 3. Barbui T, Masciulli A, Marfisi MR, et al. White blood cell counts and thrombosis in polycythemia vera: a subanalysis of the CYTO-PV study. Blood. 2015;126(4):560-561. 4. Emanuel RM, Dueck AC, Geyer HL, et al. Myeloproliferative neoplasm (MPN) symptom assessment form total symptom score: prospective international assessment of an abbreviated symptom burden scoring system among patients with MPNs. J Clin Oncol. 2012;30(33):4098-4103. 5. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Myeloproliferative Neoplasms V.1.2024. © National Comprehensive Cancer Network, Inc. 2023. All rights reserved. Accessed January 4, 2024. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way. 6. Jakafi [package insert]. Wilmington, DE: Incyte Corporation. 7. Barbui T, Barosi G, Birgegard G, et al. Philadelphia-negative classical myeloproliferative neoplasms: critical concepts and management recommendations from European LeukemiaNet. J Clin Oncol. 2011;29(6):761-770. 8. Vannucchi AM, Kiladjian JJ, Griesshammer M, et al. Ruxolitinib versus standard therapy for the treatment of polycythemia vera. N Engl J Med. 2015;372(5):426-435. Supplementary appendix available at: https://www.nejm.org/doi/suppl/10.1056/NEJMoa1409002/suppl_file/nejmoa1409002_appendix.pdf.
Indications and Usage
Jakafi® (ruxolitinib) is indicated for treatment of polycythemia vera (PV) in adults who have had an inadequate response to or are intolerant of hydroxyurea.
Jakafi is indicated for treatment of intermediate or high-risk myelofibrosis (MF), including primary MF, post–polycythemia vera MF and post–essential thrombocythemia MF in adults.
Jakafi is indicated for treatment of steroid-refractory acute graft-versus-host disease (aGVHD) in adult and pediatric patients 12 years and older.
Jakafi is indicated for treatment of chronic graft-versus-host disease (cGVHD) after failure of one or two lines of systemic therapy in adult and pediatric patients 12 years and older.
Important Safety Information
Please see Full Prescribing Information for Jakafi.
Indications and Usage
Jakafi® (ruxolitinib) is indicated for treatment of polycythemia vera (PV) in adults who have had an inadequate response to or are intolerant of hydroxyurea.
Jakafi is indicated for treatment of intermediate or high-risk myelofibrosis (MF), including primary MF, post–polycythemia vera MF and post–essential thrombocythemia MF in adults.
Jakafi is indicated for treatment of steroid-refractory acute graft-versus-host disease (aGVHD) in adult and pediatric patients 12 years and older.
Jakafi is indicated for treatment of chronic graft-versus-host disease (cGVHD) after failure of one or two lines of systemic therapy in adult and pediatric patients 12 years and older.
Important Safety Information
Please see Full Prescribing Information for Jakafi.