CYTO-PV
CYTO-PV settled the most basic question in PV: keeping the haematocrit under 45 percent gives far fewer serious clots and cardiovascular deaths than a looser target.
Overview
CYTO-PV randomised 365 adults with polycythaemia vera to a haematocrit target below 45 percent or between 45 and 50 percent, achieved with phlebotomy and hydroxyurea. After a median of 31 months the primary endpoint of cardiovascular death or major thrombosis occurred in 2.7 percent of the low-target group and 9.8 percent of the high-target group (Marchioli and colleagues, New England Journal of Medicine 2013). The result made 45 percent the universal target.
- 2.7 vs 9.8 out of 100 reached this endpoint with Haematocrit below 45% compared with Haematocrit 45 to 50%; 7.1 fewer per 100.
- On this measure the first group did worse, not better.
- This endpoint is not one of the standard survival or response measures; read it alongside the trial's primary result.
- These results apply to the people the trial enrolled: Polycythaemia vera: haematocrit target below 45 percent versus 45 to 50 percent. People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
365 participants enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Cardiovascular death or major thrombosisprimary | Haematocrit below 45% | 182 | 2.7% | - | - | - |
| Haematocrit 45 to 50% | 183 | 9.8% |
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