Ruxolitinib versus Standard Therapy for the Treatment of Polycythemia Vera

New England Journal of Medicine 372(17):1670 (2015) PMID 25901432

To the Editor: Vannucchi et al. (Jan. 29 issue)1 report that ruxolitinib was superior to standard therapy in patients with polycythemia vera who had an inadequate response to or had unacceptable side effects from hydroxyurea. The primary end point included hematocrit control and a reduction in spleen size. We wonder why the latter was included, because spleen size influences neither the risk of thrombosis or hemorrhage nor the prognosis in patients with polycythemia vera. We also wonder why the leukocyte and platelet counts were excluded in the composite assessment, when they significantly influence the risk of thrombosis and hemorrhage, respectively. . . .

DOI: 10.1056/NEJMc1502524