In this episode of the Oncology Brothers podcast, we had the pleasure of welcoming Dr. Andrew Kuykendall, a hematologist from Moffitt Cancer Center, to discuss myeloproliferative neoplasms (MPNs), specifically focusing on polycythemia vera (PV) and essential thrombocythemia (ET).
We began by exploring the workup for suspected PV, emphasizing the importance of ruling out secondary causes of erythrocytosis. Dr. Kuykendall highlighted the utility of JAK2 mutation testing and EPO levels, as well as the role of bone marrow biopsies in confirming diagnoses. He also discussed the increasing recognition of SGLT2 inhibitors as a potential cause of erythrocytosis.
As we moved into treatment paradigms, Dr. Kuykendall explained the risk stratification for PV patients based on age and history of thromboembolic events. He outlined the standard treatment approaches, including the use of aspirin and phlebotomy, as well as cytoreductive therapies like hydroxyurea and interferon. We also touched on the emerging role of ruxolitinib for symptomatic relief.
In discussing ET, we reviewed the importance of identifying driver mutations such as JAK2, CALR, and MPL, and the implications for risk stratification and treatment. Dr. Kuykendall emphasized the need to consider acquired von Willebrand disease before initiating aspirin therapy in patients with high platelet counts.
Throughout the episode, we highlighted the significance of individualized treatment plans and the need for shared decision-making with patients. Dr. Kuykendall's insights into the evolving treatment landscape for PV and ET provided valuable information for both clinicians and patients navigating these complex conditions.