{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T09:43:56Z","timestamp":1792143836596,"version":"4.4.0"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":288,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Hematology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Polycythaemia vera (PV) is associated with substantial arterial and venous thrombotic risk, particularly in patients with prior thrombosis and inadequate haematocrit (HCT) control. Although ruxolitinib is an established second\u2010line treatment after hydroxyurea failure or intolerance, some patients remain difficult to manage. We report a case of highly thrombotic, treatment\u2010challenging PV in which pacritinib\u2010based salvage therapy was used after inadequate disease control with hydroxyurea and ruxolitinib.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 44\u2010year\u2010old man was referred with portal vein thrombosis and a history of premature myocardial infarction and cerebrovascular accident. Investigations demonstrated JAK2V617F\u2010positive PV with borderline low erythropoietin and bone marrow panmyelosis. Despite antiplatelet therapy, anticoagulation, hydroxyurea and subsequent ruxolitinib, the patient experienced further thrombotic complications, including recurrent cerebrovascular events, bilateral limb ischaemia and left ventricular thrombosis. Ruxolitinib was escalated to 25\u2009mg twice daily and combined with low\u2010dose hydroxyurea; however, HCT control remained suboptimal, with recurrent need for venesection. In February 2025, ruxolitinib was replaced with pacritinib 200\u2009mg twice daily while hydroxyurea and warfarin were continued. During follow\u2010up, the patient achieved improved HCT control, no longer required venesection and had no further documented thrombotic events. Pacritinib was well tolerated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case describes a patient with high\u2010risk, refractory PV and recurrent arterial and venous thrombosis in whom pacritinib\u2010based salvage therapy was associated with improved HCT control, cessation of venesection and absence of further thrombosis during follow\u2010up. Although off\u2010label and hypothesis\u2010generating, this experience supports further evaluation of pacritinib in selected patients with treatment\u2010challenging PV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/crh\/8282682","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T08:45:05Z","timestamp":1792140305000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pacritinib\u2010Based Salvage Therapy in High\u2010Risk Polycythaemia Vera With Recurrent Arterial and Venous Thrombosis After Hydroxyurea and Ruxolitinib: A Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5827-8978","authenticated-orcid":false,"given":"Muna","family":"Al-Rasheed","sequence":"first","affiliation":[{"name":"Haematology Unit Internal Medicine Department Adan Hospital MOH  Hadiya Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.27002"},{"key":"e_1_2_13_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2023.107420"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1208500"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2015.09.1024"},{"key":"e_1_2_13_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13291"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1409002"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)30558-7"},{"key":"e_1_2_13_8_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15010011"},{"key":"e_1_2_13_9_2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2023010151"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(17)30027-3"},{"key":"e_1_2_13_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2017.5818"},{"key":"e_1_2_13_12_2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020003314"},{"key":"e_1_2_13_13_2","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2023.284488"},{"key":"e_1_2_13_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26896"},{"key":"e_1_2_13_15_2","doi-asserted-by":"publisher","DOI":"10.12659\/AJCR.944202"},{"key":"e_1_2_13_16_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V126.23.58.58"},{"key":"e_1_2_13_17_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-022-32928-3"},{"key":"e_1_2_13_18_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.683401"}],"container-title":["Case Reports in Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crh\/8282682","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crh\/8282682","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crh\/8282682","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T08:45:06Z","timestamp":1792140306000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crh\/8282682"}},"subtitle":[],"editor":[{"given":"Kalyani","family":"Sen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/crh\/8282682"],"URL":"https:\/\/doi.org\/10.1155\/crh\/8282682","archive":["Portico"],"relation":{},"ISSN":["2090-6560","2090-6579"],"issn-type":[{"value":"2090-6560","type":"print"},{"value":"2090-6579","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-05-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"8282682"}}