How important is molecular response (allele burden) for PV treatment?

Nothing helpful to say; but following along, as I have PV and am told I am at higher risk for myelofibrosis. Currently taking HU, but understand Besremi will be better for addressing that allele load at the source, and hope to discuss with my dr soon.

When I get my Jak2 test in December, if the allele burden doesn't get much better, I will seek to ask my hematologist to proceed with one of the options. I am retiring at the end of the year, so it will be easier to manage a little extra fatigue.

I have been slowly removing HU and starting with Besremi 50 mcg every two weeks. All my labs were great except platelets which were 520. I am on my third injection so I will go to 100 mcg and drop the HU entirely. This will be interesting. My JAK 2 had gone from 15 to 68% over 6 yrs.

Has anyone been told they are too old to start Besremi because it takes too long to make a difference? I am a very active and healthy 78 and in spite of my doctor trying to get me to stay on HU and phlebs and doing great, I’m going for Besremi.

Hi @mcsulli This will be interesting to follow your case along with your switching to Besremi from HU. According to the Besremi website, 27% of patients saw comprehensive disease control in 10 weeks! That’s remarkable.
Here’s the informational article from Besremi. https://besremi.com/pv/wp-content/uploads/sites/2/2026/07/BESREMi-what-to-expect-guide.pdf

Have you been doing well with the injections?

I have only had two and it went ok with no real identifiable side effects. Tomorrow is my third and increasing to 100 and I believe I am to go off HU entirely and try it for two weeks. I have not gotten a response from the doctor as to any more Hu or not. Hopefully they will let me know because another option he had suggested Hu every three days before I go totally off. I’m expecting some kind of reaction with twice the dose of Besremi but we shall see.