• Phlebotomy In Polycythemia Underused

    From ironjustice@21:1/5 to All on Mon Dec 3 05:03:00 2018
    Phlebotomy In Polycythemia Underused
    The impact of phlebotomy and hydroxyurea on survival and risk of thrombosis among older patients with polycythemia vera
    Nikolai A. Podoltsev, Mengxin Zhu, Amer M. Zeidan, Rong Wang, Xiaoyi Wang, Amy J. Davidoff, Scott F. Huntington, Smith Giri, Steven D. Gore and Xiaomei Ma
    Blood Advances 2018 2:2681-2690; doi: https://doi.org/10.1182/bloodadvances.2018021436
    ArticleFigures & DataInfo & Metrics PDF
    Key Points
    Treatments with therapeutic phlebotomy and HU are associated with improved OS and decreased risk of thrombosis in older PV patients.

    Phlebotomy and HU are underused in our sample of older PV patients.

    Abstract
    Current guidelines recommend therapeutic phlebotomy for all polycythemia vera (PV) patients and additional cytoreductive therapy (eg, hydroxyurea [HU]) for high-risk PV patients. Little is known about the impact of these therapies in the real-world
    setting. We conducted a retrospective cohort study of older adults diagnosed with PV from 2007 to 2013 using the linked Surveillance, Epidemiology, and End Results–Medicare database. Multivariable Cox proportional hazards models were used to assess the
    effect of phlebotomy and HU on overall survival (OS) and the occurrence of thrombotic events. Of 820 PV patients (median age = 77 years), 16.3% received neither phlebotomy nor HU, 23.0% were managed with phlebotomy only, 19.6% with HU only, and 41.1%
    with both treatments. After a median follow-up of 2.83 years, 37.2% (n = 305) of the patients died. Phlebotomy (yes/no; hazard ratio [HR] = 0.65; 95% confidence interval [CI], 0.51-0.81; P < .01), increasing phlebotomy intensity (HR = 0.71; 95% CI, 0.65-
    0.79; P < .01), and a higher proportion of days covered (PDC) by HU were all significantly associated with lower mortality. When thrombosis was the outcome of interest, phlebotomy (yes/no; HR = 0.52; 95% CI, 0.42-0.66; P < .01) and increasing phlebotomy
    intensity (HR = 0.46; 95% CI, 0.29-0.74; P < .01) were significantly associated with a lower risk of thrombotic events, so was a higher HU PDC. In this population-based study of older adults with PV reflecting contemporary clinical practice, phlebotomy
    and HU were associated with improved OS and decreased risk of thrombosis. However, both treatment modalities were underused in this cohort of older PV patients.

    http://www.bloodadvances.org/content/2/20/2681?rss=1&sso-checked=true

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    Recommended therapies for polycythemia vera underused
    November 27, 2018

    (HealthDay)—Among older patients with polycythemia vera (PV), therapeutic phlebotomy and hydroxyurea (HU) are associated with improved overall survival and decreased risk for thrombosis but are underused, according to a study recently published in
    Blood Advances.


    Nikolai A. Podoltsev, M.D., Ph.D., from Yale University in New Haven, Connecticut, and colleagues conducted a retrospective cohort study in 820 older adults (median age, 77 years) diagnosed with PV from 2007 to 2013 using the linked Surveillance,
    Epidemiology, and End Results-Medicare database.

    The researchers found that 16.3 percent of patients received neither phlebotomy nor HU, 23 percent were managed with phlebotomy only, 19.6 percent were managed with HU only, and 41.1 percent were managed with both treatments. During a median of 2.83
    years of follow-up, 37.2 percent of patients died. Lower mortality was significantly associated with phlebotomy (yes/no; hazard ratio [HR], 0.65), increasing phlebotomy intensity (HR, 0.71), and a higher proportion of days covered by HU. There was a
    lower risk for thrombotic events associated with phlebotomy (yes/no; HR, 0.52) and increasing phlebotomy intensity (HR, 0.46). A higher proportion of days covered by HU was also associated with a significantly lower risk for thrombotic events.

    "In this population-based study of older adults with PV reflecting contemporary clinical practice, phlebotomy and HU were associated with improved overall survival and decreased risk of thrombosis," the authors write. "However, both treatment
    modalities were underused."

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    Tom


    Jesus Was A Vegetarian!
    http://tinyurl.com/634q5a

    Man Is A Herbivore!
    http://tinyurl.com/4rq595

    DEAD PEOPLE WALKING
    http://tinyurl.com/zk9fk

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  • From ironjustice@21:1/5 to All on Mon Dec 3 04:25:30 2018
    Recommended therapies for polycythemia vera underused
    November 27, 2018

    (HealthDay)—Among older patients with polycythemia vera (PV), therapeutic phlebotomy and hydroxyurea (HU) are associated with improved overall survival and decreased risk for thrombosis but are underused, according to a study recently published in
    Blood Advances.


    Nikolai A. Podoltsev, M.D., Ph.D., from Yale University in New Haven, Connecticut, and colleagues conducted a retrospective cohort study in 820 older adults (median age, 77 years) diagnosed with PV from 2007 to 2013 using the linked Surveillance,
    Epidemiology, and End Results-Medicare database.

    The researchers found that 16.3 percent of patients received neither phlebotomy nor HU, 23 percent were managed with phlebotomy only, 19.6 percent were managed with HU only, and 41.1 percent were managed with both treatments. During a median of 2.83
    years of follow-up, 37.2 percent of patients died. Lower mortality was significantly associated with phlebotomy (yes/no; hazard ratio [HR], 0.65), increasing phlebotomy intensity (HR, 0.71), and a higher proportion of days covered by HU. There was a
    lower risk for thrombotic events associated with phlebotomy (yes/no; HR, 0.52) and increasing phlebotomy intensity (HR, 0.46). A higher proportion of days covered by HU was also associated with a significantly lower risk for thrombotic events.

    "In this population-based study of older adults with PV reflecting contemporary clinical practice, phlebotomy and HU were associated with improved overall survival and decreased risk of thrombosis," the authors write. "However, both treatment modalities
    were underused."

    Who loves ya.
    Tom


    Jesus Was A Vegetarian!
    http://tinyurl.com/634q5a

    Man Is A Herbivore!
    http://tinyurl.com/4rq595

    DEAD PEOPLE WALKING
    http://tinyurl.com/zk9fk

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