Clinical characteristics and treatment results of patients diagnosed with polycythemia vera, WHO applied to the hematology polyclinic of Karadeniz Technical University Faculty of Medicine between 2010-2020

SUMMARY Objective: In this study, it was aimed to evaluate the demographic characteristics, laboratory values at the time of diagnosis, clinical symptoms, treatment methods and complications observed during follow-up of polycythemia vera patients. Materials and Methods: In the Karadeniz Technical University, Farabi Hospital Hematology Polyclinic, a total of 1021 patients with a diagnosis of polycythemia vera followed between 2010 and 2020 were identified, and the data of 165 patients who met the study criteria were analyzed. Patients' age, gender, date of diagnosis, date of last visit, spleen size, laboratory tests at the time of diagnosis, additional diseases, genetic analyzes (Janus-type tyrosine kinase 2 (JAK2), exon 12), bone marrow findings, complications and treatments were recorded. Findings: In this study, 165 patients, 44 (26.7%) women and 121 (73.3%) men, with a mean age of diagnosis of 58.2 ± 12.6, were evaluated. Patients' most common symptoms of presentation were headache (19%), tinnitus (17.6%), itching (16.7%) and fatigue (14.8%); the most common comorbidities were hypertension (35.8%), coronary artery disease (25.6%), and diabetes mellitus (16.8%). Splenomegaly was present in 52.3% of the patients. JAK2 mutation was positive of the 94.4% patients. Of the patients were considered, 97 (58.8%) low-risk and 68 (41.2%) high-risk. Considering the laboratory parameters at the time of diagnosis, the mean hemoglobin value was 17.4 ± 1.6 g/dL, the mean hematocrit value was 53.4 ± 6.4 %, the mean white blood cell value was 11.3 ± 4.4 x109/L, the mean platelet value was 471± 227x109/L, the mean lactate dehydrogenase value was 327 ± 122 U/L, mean uric acid value was found to be 6.3 ± 1.8 mg/dL. At the time of diagnosis, 47.3% of the patients had leukocytosis and 53.3% had thrombocytosis. In the follow-up, 14.7% of the patients had arterial thrombosis, 7.3% had venous thrombosis, 5.3% had myelofibrosis transformation, 1.3% had myelodysplastic syndrome, and 1.3% had bleeding. When the patients were compared according to gender, men had higher thrombosis rates and higher uric acid values, while women had higher mean white blood cell, neutrophil, mean red cell distribution width and lactate dehydrogenase values. In patients with positive JAK2 mutation mean erythrocyte distribution width, white blood cell count, neutrophil count and platelet count were found to be higher. While the mean age at 4 diagnosis, presence of chronic disease, thrombosis rates, neutrophil count and RDW values were higher in high-risk patients, albumin values were observed to be lower. In patients with thrombosis, it was determined that the presence of chronic disease, especially coronary disease was higher. In patients with thrombosis were determined higher that the presence of chronic disease, especially coronary artery disease. The mean survival time of the patients was 160.3 ± 5.5 months. In the presence of comorbidity, high risk group, and arterial thrombosis it was observed that the survival rates decreased significantly. Conclusion: In our study, the presence of chronic disease, thrombosis history and high risk were associated with increased thrombosis risk in PV patients. Therefore, in the management of PV patients, thromboembolic complications affecting morbidity and mortality and risk factors for thrombosis should be targeted. Keywords: Polycythemia vera, Thrombosis, Transformation, Survival