[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-349450-105":3,"detail-sidebar-cat-0-en-105":80,"doc-detail-349450-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","prevalence-incidence-and-risk-factors-of-secondary-malignancies-in-patients-with-polycythemia-vera-a-real-world-study","Prevalence, incidence, and risk factors of secondary malignancies in patients with polycythemia vera - a real-world study","","Real-world evidence from a retrospective cohort study evaluates secondary malignancies in polycythemia vera (PV) using Optum Market Clarity electronic health records and linked medical and pharmacy claims. Among newly or previously diagnosed PV patients, 36% had at least one non-PV malignancy over 4.3 years, with skin cancers the most common. Exposure to hydroxyurea showed nearly twofold higher incidence of new-onset melanoma or nonmelanoma skin cancer versus therapeutic phlebotomy alone. Strongest risk factors included older age, prior skin cancer history, and preindex cytoreductive medication use, with adjusted hazard ratio 1.33. ",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/research-report/","Research & 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Done","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-09-25","2026-09-22",true,{"@type":52,"interactionType":53,"userInteractionCount":26},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"What proportion of polycythemia vera patients developed secondary malignancies and over what follow-up time?","Question",{"text":62,"@type":63},"In PV patients, 28% developed secondary malignancies over 4.3 years of follow-up, corresponding to 9.6 cancers per 100 patient-years.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"Which secondary malignancies were most common in patients with polycythemia vera?",{"text":67,"@type":63},"The most common secondary malignancies were skin cancers, including basal cell carcinoma, squamous cell carcinoma, and melanoma.",{"name":69,"@type":60,"acceptedAnswer":70},"How did hydroxyurea exposure relate to the incidence of new-onset melanoma or nonmelanoma skin cancer?",{"text":71,"@type":63},"The incidence rate for a composite outcome of new-onset melanoma or nonmelanoma skin cancer was nearly twofold higher with any hydroxyurea exposure than with therapeutic phlebotomy alone, and adjusted results showed a hazard ratio of 1.33 for ≥4 weeks exposure versus none.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},349450,1790344024,{"code":4,"msg":81,"data":82},"success",[83,87,91,95,100,105,110,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},"Story & 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secondary malignancies in patients with polycythemia vera: a real-world study  \nNaveen Pemmaraju, 1 Alina Markova,2 Lucia Masarova, 1 Nancy Reaven,3 Susan Funk,3 Thomas W. Ferguson,4 Lucy Bellamy,5 Phillip Dinh,5 Pedro Oyuela,5 Frank Valone,5 Arturo Molina,5 and Suneel Gupta5  \n1 Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX; 2 Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; 3 Strategic Health Resources, La Ca˜nada, CA; 4 Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada; and 5 Protagonist Therapeutics, Inc, Newark, CA  \nKey Points  \n• Of patients with PV, 28% developed secondary malignancies over 4.3 years of follow-up (9.6 cancers per 100 patient-years) .  \n• The most common secondary malignancies were skin cancers (eg, basal cell carcinoma, squamous cell carcinoma, and melanoma) .  \nPatients with the primary myeloproliferative neoplasm polycythemia vera (PV) are at risk of the development of secondary malignancies, including skin cancers. This real-world, retrospective cohort study used Optum Market Clarity electronic health record data and linked medical and pharmacy claims from 70 million patients in the United States between 1 January 2007 and 31 December 2019 to assess the frequency of secondary malignancies in patients with a new or established diagnosis of PV (N = 82 947 with ≥1 PV diagnosis; the final cohort for this study included 20 089 patients) and the association of these cancers with patient characteristics and PV treatment. After indexing, 36% of patients had at least 1 non-PV malignancy (follow-up duration, 4.3 years) . The most common nonhematologic malignancies were skin cancers, including melanoma and nonmelanoma skin cancer (NMSC) . The incidence rate for a composite outcome of new-onset melanoma or NMSC was nearly twofold higher in patients who were exposed to hydroxyurea at any time than in those who were exposed to therapeutic phlebotomy alone. The strongest risk factors for occurrence of melanoma or NMSC in the observation period included older age, previous history of skin cancer, and preindex period use of cytoreductive medications. After controlling for potential confounders, a higher likelihood of developing new-onset melanoma or NMSC was observed in patients who received ≥4 weeks of hydroxyurea exposure vs those with no hydroxyurea exposure (hazard ratio, 1.33; 95% confidence interval, 1.17-1.50) . This finding, which may have been influenced by different disease burdens among this diverse patient population, warrants further exploration.  \nIntroduction  \nPolycythemia vera (PV) is a primary myeloproliferative neoplasm (MPN) associated with dysfunction of JAK2 V617F and other genes, leading to the excessive production of red blood cells (erythrocytosis), leukocytes, and platelets.1-5 In patients with PV, excessive erythrocytosis and dysfunction of other myeloid cell lineages can increase blood viscosity, leading to the onset of bleeding disorders (eg, acquired von Willebrand syndrome),3 as well as to an increased risk of morbidity and mortality due to thromboembolicand cardiovascular events.6-9  \nSubmitted 9 December 2025; accepted 10 April 2026; prepublished online on Blood Advances First Edition 29 April 2026. [https://doi.org/10.1182/](https://doi.org/10.1182/)[ ](https://doi.org/10.1182/)[bloodadvances.2025019349](bloodadvances.2025019349.)[.](bloodadvances.2025019349.)  \nData for this study were made available to the authors through a third-party data use agreement from Optum, a commercial data provider in the United States. Sharing of the data set is not possible because of this data use agreement.  \nThe full-text version of this article contains a data supplement.  \n© 2026 American Society of Hematology. Published by Elsevier Inc. Licensed under Creative Comm","cbCaiuFxURA73bac","https://ap.wps.com/l/cbCaiuFxURA73bac","pdf",612709,12,"English","# Key Points\n## Secondary malignancy frequency in PV\n## Skin cancer incidence and hydroxyurea exposure\n# Introduction\n## PV biology and associated risks\n## Hematologic transformation and lymphoid malignancies","[{\"question\":\"What proportion of polycythemia vera patients developed secondary malignancies and over what follow-up time?\",\"answer\":\"In PV patients, 28% developed secondary malignancies over 4.3 years of follow-up, corresponding to 9.6 cancers per 100 patient-years.\"},{\"question\":\"Which secondary malignancies were most common in patients with polycythemia vera?\",\"answer\":\"The most common secondary malignancies were skin cancers, including basal cell carcinoma, squamous cell carcinoma, and melanoma.\"},{\"question\":\"How did hydroxyurea exposure relate to the incidence of new-onset melanoma or nonmelanoma skin cancer?\",\"answer\":\"The incidence rate for a composite outcome of new-onset melanoma or nonmelanoma skin cancer was nearly twofold higher with any hydroxyurea exposure than with therapeutic phlebotomy alone, and adjusted results showed a hazard ratio of 1.33 for ≥4 weeks exposure versus none.\"}]","Prevalence, incidence, and risk factors of secondary malignancies in patients with polycythemia vera - a real-world study | PDF",1790083373]