What monitoring parameters should be routinely assessed in patients diagnosed with Polycythaemia Vera?

Routine monitoring parameters for patients with Polycythaemia Vera include:

• Regular blood tests to monitor haematocrit levels, aiming to keep haematocrit below 0.54 to reduce thrombosis risk.
• Annual full blood count to detect transformation to myelofibrosis or acute myeloid leukaemia, including assessment for anaemia, leukoerythroblastic blood picture, and changes in splenomegaly.
• Clinical assessment for constitutional symptoms such as unexplained fever, night sweats, and significant weight loss (>10% in 6 months) that may indicate disease progression.
• Cardiovascular risk assessment at diagnosis and annually using validated tools like QRISK3, with management of risk factors including hypertension, diabetes, hyperlipidaemia, and smoking cessation.
• Judicious monitoring of iron status, as iron deficiency may result from venesection; iron replacement should be carefully considered due to risk of increasing haematocrit and thrombosis.

These monitoring activities can be performed in primary care in coordination with haematology services, following local protocols.