Tag Archives: hematocrit

Understanding Hematocrit Thresholds in Polycythemia Vera Treatment

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March 19, 2025

Author(s): Maggie L. Shaw, Andrew Kuykendall, MD

In early March, The American Journal of Managed Care® spoke with Andrew Kuykendall, MD, a clinical researcher at Moffitt Cancer Center who focuses on myeloproliferative neoplasms (MPNs), myelodysplastic syndrome/MPN overlap syndromes, and systemic mastocytosis. Kuykendall is an investigator on the phase 3 VERIFY trial (NCT05210790) of the injectable hepcidin mimetic rusfertide (Takeda) to treat polycythemia vera (PV) by enabling patients to achieve and sustain hematocrit control.1 Hematocrit is the measure of the percentage of red blood cells in the body.2

Treatment guidelines in PV currently recommend maintaining hematocrit below 45%, with a higher threshold for men vs women.2 For part 2 of this interview, Kuykendall explains the reasoning behind having different hematocrit thresholds.

In the first part of the interview, Kuykendall discussed how PV manifests and common ways to reduce its negative impact on patient quality of life.

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MPN Word of the Month: Hematocrit

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Hematocrit is a key measurement in hematology that represents the proportion of blood volume occupied by red blood cells (RBCs). Expressed as a percentage, it provides crucial insights into an individual’s red blood cell mass and overall blood health. Typically, hematocrit levels are assessed through a routine blood test, often as part of a complete blood count (CBC).

In the context of myeloproliferative neoplasms (MPNs)—hematocrit plays a significant role in diagnosis and management. Polycythemia vera, essential thrombocythemia, and myelofibrosis each affect blood cell production but in different ways.

  1. Polycythemia Vera (PV): One of the indicators of PV is an elevated hematocrit level. In PV, the bone marrow produces an excess of red blood cells, leading to a high hematocrit. This can increase how thick the blood is (viscosity), potentially causing complications such as blood clots, strokes, or heart attacks. Regular monitoring of one’s hematocrit is essential for managing PV and assessing the effectiveness of treatments aimed at reducing the risk of these complications.
  2. Essential Thrombocythemia (ET): While ET primarily involves elevated platelet counts, a high hematocrit may also be observed due to secondary effects or overlapping features with other MPNs. Management focuses on controlling platelet levels to prevent thrombotic events, but monitoring hematocrit remains important for comprehensive disease management.
  3. Primary Myelofibrosis (PMF): In PMF, hematocrit levels may be low due to the replacement of bone marrow with fibrous tissue, leading to anemia. The disease’s progression can cause varying hematocrit levels, which are crucial for tracking disease progression and response to treatment.

In summary, hematocrit is more than just a routine blood test value; it is a vital indicator in the diagnosis, treatment, and management of myeloproliferative neoplasms.