Thrombotic Risk Stratification in PV

The panel reviews current approaches to assessing thrombotic risk. Traditional models focus on age and prior thrombosis history, which provide a foundation for clinical decisions. However, they emphasize that these criteria may not fully capture individual patient risk. Emerging evidence suggests factors such as white blood cell count, molecular markers, and inflammatory pathways influence thrombosis but are not yet incorporated into widely accepted frameworks. The experts acknowledge the need for more refined stratification tools validated in clinical practice. They discuss challenges clinicians face when deciding whether patients classified as “low risk” might still benefit from cytoreductive therapy based on functional status or symptom burden. The conversation underscores ongoing efforts to integrate additional biologic data into risk assessment to better tailor therapy and reduce preventable events while acknowledging that guidelines evolve slowly due to the need for robust evidence.