What are the treatments for polycythemia vera (PV)?

Doctors treat PV with a technique called phlebotomy. This procedure removes blood from your body. Red blood cells contain large amounts of iron. By removing iron from the body, the production of red blood cells by the bone marrow slows down.

During phlebotomy, a health professional will insert a needle into a vein and drain blood through a tube into a container. People with a new PV diagnosis typically undergo phlebotomy once a week until their red blood cell level becomes closer to normal. After that, they may have phlebotomy every three months to keep levels normal.

Doctors also prescribe medicines to treat PV. The most common drug used to treat PV is hydroxyurea (Hydrea®, Droxia®). This medicine helps slow the production of red blood cells. Some people with PV take aspirin every day because it helps thin the blood.

Two other drugs used to treat PV are ruxolitininib (Jakafi®), which is used for patients who do not respond to or cannot take hydroxyurea. Pegylated interferon (Pegasis®), is used to treat hepatitis C. However, an off-label use for the interferon has been used to treat patients with PV.

What are the complications of polycythemia vera (PV)?

The most dangerous complication of PV is a blood clot. When a clot travels to the heart or brain, it can cause a heart attack or stroke. A clot can also travel to the lungs (pulmonary embolism). These events can be fatal.

A bone marrow disorder called myelofibrosis is another potential complication of PV. Myelofibrosis leads to scarring in the bone marrow and anemia (low red blood cell count). In rare cases, PV can develop into a blood cancer called acute myeloid leukemia (AML). AML can lead to anemia and infection, and spread beyond the blood to other areas in the body.

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