Thrombosis‐Driven Disease Progression in JAK2‐Mutant Polycythemia Vera and Essential Thrombocythemia: Reassessing Risk‐Based Management

ABSTRACT This paper explores emerging therapies in polycythemia vera and essential thrombocythemia, focusing on thrombosis as a driver of disease progression leading to myelofibrosis, blast phase, second cancers, and mortality. While the thrombosis rate in high‐risk patients has declined, it remains persistently high in low‐risk individuals, with most events being arterial. Inflammation driven by JAK2 V617F mutation plays a primary role in pathogenesis, and mounting evidence suggests arterial thrombosis itself can fuel a self‐sustaining cycle of inflammation, thereby accelerating hematologic and systemic complications. Early intervention with cytoreductive and anti‐inflammatory drugs may not only prevent incidental thrombosis but also disrupt this inflammatory circuit.