Resumen
The prognostic relevance of a patient achieving complete response to hydroxyurea, the predictors of response, and patients? triggers for switching to ruxolitinib are uncertain. A retrospective, real-world analysis was performed on 563 polycythemia vera patients treated with hydroxyurea for =12 months during an observational ?PV-NET? Italian study. We investigated factors associated with a complete response to hydroxyurea and outcomes of the 397 poor responders to hydroxyurea according to whether they subsequently received ruxolitinib (n = 114) or continued hydroxyurea (n = 283). The results suggest that many PV patients receive underdosed hydroxyurea, leading to lower response and toxicity rates. In addition, many patients continued hydroxyurea despite a poor clinical or hematological response; however, splenomegaly and other symptoms were the main drivers of an early switch. Better HU management, standardization of the criteria for and timing of responses to HU, and adequate intervention in poor responders should be advised.