A patient with polycythaemia vera (PV) has not responded to phlebotomy and low-dose aspirin and has recurrent thrombotic events. According to WHO/ELN guidelines, the MOST appropriate cytoreductive therapy is:
- A Busulfan
- B Hydroxyurea (hydroxycarbamide) ✓
- C Anagrelide
- D Imatinib
Correct answer: B. Hydroxyurea (hydroxycarbamide)
Explanation
Hydroxyurea (hydroxycarbamide) is the first-line cytoreductive therapy for high-risk PV (age >60 or prior thrombotic event) per ELN 2018 and WHO guidelines. It reduces haematocrit, white cell count, platelet count, and thrombotic risk. Busulfan is reserved for older patients intolerant of or refractory to hydroxyurea. Anagrelide is used in essential thrombocythaemia, not as first-line in PV. Imatinib targets BCR-ABL and has no role in PV (JAK2 V617F disease).
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.