Frequency, Risk stratification, Complications and Outcome of Polycythemia Vera: A Single Institute Experience.

Abstract

Objectives: To evaluate the frequency of PV among patients with high hemoglobin and hematocrit, risk stratification, complications, and long-term outcomes of PV patients in a single institute tertiary care setting.

Methodology: This retrospective cohort study is conducted at Aga Khan University Hospital, Karachi, duration from January 2020 to December 2024. Sixty nine patients  were diagnosed with PV based on WHO 2022 criteria and molecular testing out of 450 who presented with erythrocytosis. Data was extracted from electronic medical records and analyzed using SPSS.

Results: The prevalence of JAK2-positive PV was 15.3% (n=69) among patients presented with erythrocytosis. Cohort showed a male predominance (66.7%) with a mean age of 58.5 years. Hypertension (56.5%) and headache (55.1%) were the most common comorbidity and symptom assessed, respectively. High-risk patients constituted 63.8% of cases. Pre-treatment thrombotic events observed exclusively in the high-risk group (52.3%). Post-treatment complications (including arterial/venous events, leukemic transformation, and secondary malignancies) were observed in 20.5% of high-risk patients, however low-risk patients experienced no complications. The overall 5-year mortality rate was 8.7%, entirely in the high-risk group. 65.2% of the total cohort remained alive at the final follow-up.

Conclusion: Significant thrombotic morbidity and mortality were observed in high risk patients of PV in this South Asian cohort. These findings emphasize the inevitability of early molecular diagnosis, risk-adapted cytoreductive therapy, and structured long-term monitoring to improve clinical outcomes.

Key Words: Lupus Anticoagulants, Systemic Lupus Erythemotosis, Miscarriages, Venous Thrombosis