Polycythemia Vera
Not yet clinically reviewed
This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.
Polycythemia vera is a type of blood cancer. It causes bone marrow to make too many red blood cells. These excess cells thicken blood, slowing its flow, which may cause serious problems, such as blood clots. Polycythemia vera is rare. It usually develops slowly, and person might have it for years without knowing. Without treatment, polycythemia vera can be life-threatening
Symptoms
- Itchiness, especially after a warm bath or shower
- Numbness, tingling, burning, or weakness in your hands, feet, arms or legs
- A feeling of fullness soon after eating and bloating or pain in your left upper abdomen due to an enlarged spleen
- Unusual bleeding, such as a nose-bleed or bleeding gums
- Painful swelling of one joint, often the big toe
- Shortness of breath
Diagnosis
- CBC
- Bone marrow testing
- Specific gene testing
Treatment
- Hydroxyurea 0.5-2g/day
- Ruxolitinib 10mg twice a day
- Interferon-alpha 500,000-Imillion Ul progressively increase to 2–3 million
- Ropeginterferon alpha 2b Starting dose 45 ug weekly and titrated monthly in 45 ug increments up to a maximum of 180 ug weekly
- Phlebotomy To maintain Hct <45% This decreases your blood volume and reduces the number of excess blood cells
- Aspirin 81-100 mg daily
- Busulfan cycles at 2 mg/day