The diagnosis and management of polycythemia vera in the era since the Polycythemia Vera Study Group: a survey of American Society of Hematology members' practice patterns
The diagnosis and management of polycythemia vera in the era since the Polycythemia Vera Study Group: a survey of American Society of Hematology members' practice patterns
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DOI：
10.1182/blood.v99.4.1144
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发表时间：
2002-02-15
期刊：
影响因子：
20.3
通讯作者：
Spivak, JL
中科院分区：
文献类型：
--
作者：
Streiff, MB;Smith, B;Spivak, JL
真性红细胞增多症研究小组(PVSG)成立于1967年，旨在确定诊断和治疗真性红细胞增多症(PV)的最佳方法。然而，对美国医生治疗PV的方法还没有进行系统的评估。为了确定PV管理中的实践模式，对美国血液学会(ASH)成员的随机抽样进行了调查。在3000份调查中，33%的调查被退回。诊断和治疗方法的显著差异因地区、实践类型、专业和临床经验而明显不同。红细胞体积测定(78%的受访者)、血清促红细胞生成素水平(76%)和动脉血气(75%)是诊断PV最常用的检测方法。69%的医生将静脉采血作为红细胞增多症的首选。静脉置管加羟基尿素(27.8%)和单纯羟基尿素(10%)使用频率较低。尽管PVSG建议，几乎16%的医生使用0.55(50%)或0.55(55%)的目标红细胞压积进行静脉采血治疗。82%的医生仅在血小板计数超过1000x10(9)/L(1000000/MUL)或出现症状时才治疗血小板增多症。治疗血小板增多症的主要药物为羟基脲(62.8%)和阿格列德(35.4%)。因此，这项对美国血液学家和肿瘤学家的全国性调查发现，PV的诊断和治疗方法存在显著差异。相当少数的内科医生对红细胞增多症治疗不足，对于血小板增多症的治疗也几乎没有达成共识。(C)2002年，由美国血液病学会公布。
The Polycythemia Vera Study Group (PVSG) was organized in 1967 to identify the optimal approach to the diagnosis and treatment of polycythemia vera (PV). Nevertheless, a systematic assessment of US physicians' approach to PV has not been performed. To determine practice patterns in the management of PV, a random sample of the US American Society of Hematology (ASH) membership was surveyed. Thirty-three percent of 3000 surveys were returned. Significant variations In diagnostic and therapeutic approach were evident by region, practice type, specialty, and clinical experience. Red cell volume determinations (78% of respondents), serum erythropoietin levels (76%), and arterial blood gases (75%) were the most frequent tests used in the diagnosis of PV. Sixty-nine percent of physicians use phlebotomy as their first choice for erythrocytosis. Phlebotomy plus hydroxyurea (27.8%) and hydroxyurea alone (10%) were used less often. Despite PVSG recommendations, almost 16% of physicians used a target hematocrit of 0.55 (50%) or 0.55 (55%) for phlebotomy therapy. Eighty-two percent of physicians treated thrombocytosis only when platelet counts exceeded 1000 x 10(9)/L (1 000 000/muL) or In the event of symptoms. Hydroxyurea (62.8%) and anagrelide (35.4%) were the primary agents used to treat thrombocytosis. Thus, this national survey of US hematologists and oncologists has Identified substantial variation in the approach to the diagnosis and treatment of PV. A significant minority of physicians undertreat erythrocytosis, and little consensus exists regarding the treatment of thrombocytosis. (C) 2002 by The American Society of Hematology.