Course Summary

Expiration Date: 08/22/2029

Polycythemia vera is a chronic myeloproliferative neoplasm characterized by clonal erythrocytosis, most commonly driven by activating JAK2 mutations, and is associated with a high risk of arterial and venous thrombosis. This activity provides a concise, evidence-based review of disease biology, clinical presentation, and contemporary diagnostic criteria, with emphasis on confirmation of true erythrocytosis, exclusion of secondary causes, and early recognition of atypical thrombotic manifestations. Guideline-aligned management strategies are reviewed, including therapeutic phlebotomy, antiplatelet therapy, risk-adapted cytoreductive treatment, anticoagulation considerations, and symptom-directed care, with attention to longitudinal monitoring, special populations, and interdisciplinary management to reduce complications and support long-term outcomes.

Course Format

Homestudy

Course Syllabus

  • Introduction
  • Disease Biology and Pathophysiology
  • Clinical Presentation and Symptom Burden
  • Diagnostic Framework
    • Role of Bone Marrow Biopsy
    • Differential Diagnosis and Exclusion of Secondary Causes
    • Special Diagnostic Scenarios
  • Risk Stratification
    • Core Thrombosis Risk Model
    • Additional Risk Modifiers (Risk Enrichment)
    • Prognosis and Survival
    • Optional Advanced Prognostic Models
  • Treatment Goals and Principles
    • Universal Baseline Therapy
    • Risk-Adapted Therapy Selection
  • Therapeutic Phlebotomy in Detail
    • Target Hematocrit and Evidence Base
    • Practical Implementation
    • Monitoring Response
    • Special Considerations
  • Antiplatelet Therapy in Detail
    • Managing Bleeding Risk
    • What Is Not Established
    • Twice-Daily Aspirin: Advanced Considerations
  • Cytoreductive Therapy
    • Indications for Cytoreduction
    • Response Goals and Monitoring
  • Anticoagulation and Thrombosis Management
    • Principles of Anticoagulation
    • Management in Patients With Prior Venous Thrombosis
  • Symptom-Focused and Supportive Management
    • Pruritus Management
    • Microvascular Symptom Control
    • Management of Splenomegaly-Related Symptoms
    • Patient Education and Self-Management
  • Monitoring and Follow-Up
    • Routine Monitoring Elements
    • Monitoring for Complications
    • Triggers for Hematology Escalation or Therapy Change
  • Special Populations and High-Risk Situations
    • Pregnancy and Reproductive Considerations
    • Splanchnic Vein and Cerebral Venous Sinus Thrombosis
    • Perioperative Management
    • Older Adults and Frailty
  • Outcomes and Prognosis
    • Thrombosis Timing and Lifetime Burden
    • Bleeding Outcomes
    • Disease Progression Outcomes
    • Survival Expectations
  • Clinical Decision Pathway
    • Initial Evaluation Pathway
    • Initial Treatment Pathway After Diagnosis
    • Risk-Adapted Treatment Escalation
    • Second-Line and Subsequent Therapy
  • Case Study: Concurrent Polycythemia Vera and Stiff-Person Syndrome
    • Background
    • Case Presentation
    • Discussion
  • Summary

Authors

Richard Daniels, PharmD, BCPS

Richard “Cole” Daniels earned his Doctor of Pharmacy(PharmD) from the Skaggs School of Pharmacy at the University of Montana in 2018. Throughout pharmacy school he completed a 3-year internship at Community Medical Center in Missoula, Montana in which he gained valuable experience in an acute care setting. Cole currently serves as a psychiatric clinical staff pharmacist at the Montana State Hospital. He has over 11 years of pharmacy experience having worked in several settings including retail, acute care, and inpatient psychiatric care. Cole has a diverse set of interests. However, acute care medicine, infectious disease, pain management, and asthma/COPD are a primary focus of his at the Montana State Hospital. He obtained board certification as a certified pharmacotherapy specialist in the Spring of 2022.

Elisabeth Gordon, BScPharm, RPh

Elisabeth Gordon earned her BSc(Pharm) from the University of British Columbia in 2004. After graduation, she worked in community retail pharmacies on Vancouver Island, before returning to her rural hometown of Salmon Arm. In 2016 and 2017, Elisabeth trained with Pallium Canada and Victoria Hospice to enhance her knowledge of end-of-life-care and palliative services. She is a volunteer medical supervisor for T1DOutreach, a peer support platform for adults living with type 1 diabetes, and a member of a Canadian peer support group for adults living with Birdshot Uveitis. Elisabeth enjoys working in a small, fast-paced rural pharmacy where she brings compassion and empathy to her everyday practice.