PV at ASH 2025 / Polycythemia Vera 01/10/2026

Ep. 4: Managing Fatigue and Phlebotomy Burden in PV With Rusfertide

Experienced oncologist wearing a professional suit, consulting patients and advancing cancer treatment research, showcasing expertise in oncology healthcare and medical innovation. Talha Badar, MBBS, MD Professional male with glasses wearing a checkered shirt, colorful bow tie, and dark blazer, smiling against a plain background, representing medical or healthcare insights from OncUpdates. Aaron Gerds, MD Male doctor in white coat smiling, healthcare professional expert, medical doctor, clinical healthcare, medical staff, hospital, healthcare provider, medical professional, oncology specialist, medical advisor. Andrew Kuykendall, MD Smiling man with beard wearing a white shirt, professional headshot, suitable for oncology or cancer research content, emphasizing healthcare and medical expertise. Rahul Gosain, MD, MBA Oncologist smiling in white coat, highlighting cancer research and treatment expertise, with a bow tie, in a bright medical setting. Rohit Gosain, MD

Key Points

  • Rusfertide offers hematocrit control while minimizing off-target cytopenias, potentially reducing reliance on cytoreductive therapy.
  • Quality-of-life benefits include improved fatigue, reduced phlebotomy visits, and patient autonomy through self-administered therapy.
  • Iron supplementation may be considered for symptomatic deficiency; dosing should remain continuous to maintain hematocrit control.

Rusfertide and Quality-of-Life Improvements in Polycythemia Vera

During a Clinical Insights discussion, Rahul Gosain, MD, MBA, of Wilmot Cancer Institute, and Rohit Gosain, MD, of Roswell Park Comprehensive Cancer Center, explored health-related quality-of-life considerations in polycythemia vera (PV). Panelists Talha Badar, MBBS, MD, of Mayo Clinic; Aaron Gerds, MD, of Cleveland Clinic; and Andrew Kuykendall, MD, of Moffitt Cancer Center, discussed the role of rusfertide in managing hematocrit while potentially improving patient autonomy, symptom burden, and long-term outcomes.

The panel emphasized that traditional therapies, such as hydroxyurea and ruxolitinib, can control hematocrit but may lead to off-target cytopenias or cumulative toxicity. Rusfertide offers a targeted alternative with the potential to reduce reliance on frequent phlebotomies and mitigate iron deficiency–related fatigue.

Integration, Dosing, and Symptom Management

Panelists discussed optimal integration of rusfertide with existing therapies. Data suggest that while hydroxyurea dosing can be escalated, this approach may compromise platelet and white blood cell counts. Rusfertide allows hematocrit control without additional off-target toxicity and may reduce exposure to cytoreductive agents associated with secondary malignancies, such as hydroxyurea and ruxolitinib.

Regarding iron management, patients with profound iron deficiency may benefit from iron supplementation while on rusfertide, guided by clinical symptoms rather than lab values alone. Patient-reported outcomes from VERIFY indicate improvements in fatigue and other symptoms, particularly in patients with moderate to severe baseline manifestations. Self-administered subcutaneous dosing also restores autonomy by reducing clinic visits for phlebotomy, further enhancing quality of life. Continuous therapy remains essential, as temporary discontinuation leads to rapid hematocrit rebound.