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PV Case Challenge

CME

Interactive Case Challenge: Diagnosing and Managing a Patient With Polycythemia Vera

Physicians: Maximum of 0.50 AMA PRA Category 1 Credit

Released: April 14, 2026

Expiration: October 13, 2026

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The patient was diagnosed with PV. Because his age is older than 60 years and he has a history of thrombosis, he is considered at high risk for disease complications. The patient begins treatment with hydroxyurea (hydroxycarbamide) and low-dose aspirin; interferon-based therapy was also considered. However, after 2 years, he requires venesections 4-5 times/year to maintain Hct levels and is fatigued (score 9/10) and itchy (score 7/10), with impaired quality of life. A CBC shows the following: Hgb 12.5 g/dL, Hct 46%, MCV 60, platelets 700 x 109/L, WBC 12 x 109/L, and very low serum iron.

The patient arrives to discuss the next steps in his treatment.

Which of the following would be the most appropriate treatment for this patient?