Consensus on the use of ropeginterferon alfa-2b in Japanese patients with polycythemia vera: a modified Delphi survey

Polycythemia vera (PV) is a myeloproliferative neoplasm that is treated according to the patient's thrombosis risk, including cytoreductive therapies for those at high-risk for thrombosis. Ropeginterferon alfa-2b, a mono-pegylated interferon α-2b, is a new cytoreductive therapy for PV. This expert consensus study, conducted before ropeginterferon alfa-2b recommendations were added to the Japanese guidelines, used a four-phase Delphi method to survey 18 Japanese hematology experts and develop suggestions for ropeginterferon alfa-2b use in Japan. Several scenarios where ropeginterferon alfa-2b treatment is considered appropriate for patients with PV were identified, including: 1) low-risk patients requiring cytoreductive therapy (excluding low-risk patients requiring cytoreductive therapy due to splenomegaly); 2) patients intolerant or resistant to hydroxyurea treatment; 3) high-risk patients aged ≤ 70 years, even if hematocrit < 45% is achieved and maintained under hydroxyurea treatment; and 4) patients who wish to conceive or who are pregnant and require cytoreductive therapy. This is the first expert consensus study using the Delphi method to examine cytoreductive therapy for Japanese patients with PV and contributes to the appropriate selection of patients for ropeginterferon alfa-2b in clinical practice.