Douglas Tremblay, MD, assistant professor of medicine at the Icahn School of Medicine at Mount Sinai, discusses the factors which influence the decision to recommend cytoreduction for patients with essential thrombocytopenia (ET) and polycythemia vera (PV).
According to Tremblay, deciding when to start cytoreductive therapy in patients with chronic myeloproliferative neoplasms (MPN) patients like those with PV and ET hinges on accurate risk assessment. While risk stratification tools like the European LeukemiaNet (ELN) classification or the IPSET-Thrombosis score are valuable, Tremblay cautions against oversimplifying things.
He also emphasizes that different factors can indicate which patients are high-risk, including biological age and individual cardiovascular risk factors. Overall, utilizing a personalized approach to risk assessment is key when deciding on cytoreductive therapy for patients with MPN patients. Age should be considered within the context of their overall health and potential for vascular complications. With a personalized approach, experts can ensure that cytoreductive therapy is reserved for those who truly stand to benefit and avoids unnecessary treatment for others.