Minimal molecular response in polycythemia vera patients treated with imatinib or interferon alpha

Imatinib and recombinant interferon alpha (rIFN?) can induce remission in polycythemia vera (PV) patients, but gauging the depth of responses has not been possible due to lack of a specific disease marker. We found that patients undergoing imatinib (n=14) or rIFN? (n=7) therapy remained strongly positive for V617F JAK2, although there was a significant reduction in the median percentage of mutant alleles that correlated with hematologic response (P=0.001). Furthermore, individuals who achieved complete hematologic remission had lower levels of V617F than those who did not (P=0.001). Of nine imatinib-treated cases for whom pretreatment samples were available, seven with no or partial hematologic responses showed a marginal increase (median 1.2 fold, range 1.0-1.5) in the percentage of V617F alleles on treatment whereas the two patients who achieved complete hematologic remission showed a 2-3 fold reduction. Our data indicate that, although PV patients may benefit from imatinib or rIFN?, molecular responses are relatively modest