Recommendations for best management of polycythemia vera in Italy: a Delphi consensus statement

A two-round Delphi panel study assessed consensus among Italian healthcare professionals on the management of polycythemia vera (PV). Six hematologists with expertise in PV developed an online questionnaire containing 39 statements covering PV diagnosis and prognosis, treatment, management of complications, patient referral between transfusionist and hematologist, and patient education/psychosocial support. An Expert Panel of 18 transfusionists/hematologists rated their level of agreement with each statement on a 5-point Likert scale. In round 1, all 18 panelists completed the questionnaire, achieving consensus on 28/39 statements (71.8%). In round 2, 16 panelists completed the questionnaire, reaching consensus on 32/38 statements (84.2%). Overall, 81.3% of the panelists agreed that PV diagnosis/prognosis relies on established classification systems. In cases of JAK2 unmutated erythrocytosis and family history of erythrocytosis, additional mutational testing should be undertaken. Consensus was not achieved regarding the necessity of bone marrow biopsy for diagnosis. Almost all panelists (93.4%) agreed that a collaborative dialogue between transfusionists and hematologists is important.