Treatment

Polycythemia vera is a chronic condition that can't be cured. Treatment focuses on reducing your amount of blood cells. In many cases, treatment can reduce the risk of complications from polycythemia vera and ease signs and symptoms.

Treatment might include:

  • Taking blood out of your veins. Drawing some blood out of your veins in a procedure called phlebotomy is usually the first treatment option for people with polycythemia vera. This reduces the number of blood cells and decreases your blood volume, making it easier for your blood to function. How often you need phlebotomy depends on the severity of your condition.
  • Low-dose aspirin. Your doctor may recommend that you take a low dose of aspirin to reduce your risk of blood clots. Low-dose aspirin may also help reduce burning pain in your feet or hands.
  • Medication to decrease blood cells. For people with polycythemia vera who aren't helped by phlebotomy alone, medications, such as hydroxyurea (Droxia, Hydrea), to suppress your bone marrow's ability to produce blood cells might be used.

    Interferon alpha may be used to stimulate your immune system to fight the overproduction of red blood cells. It might be used for people who don't respond well to hydroxyurea. It's being studied in clinical trials.

  • Medication to destroy cancer cells. Ruxolitinib (Jakafi) is approved by the Food and Drug Administration to treat people with polycythemia vera who don't respond to or can't take hydroxyurea. It helps your immune system destroy cancer cells, and can improve some polycythemia vera symptoms.
  • Therapy to reduce itching. If you have bothersome itching, your doctor may prescribe medication, such as antihistamines, or recommend ultraviolet light treatment to relieve your discomfort.

    Medications that are normally used to treat depression, called selective serotonin reuptake inhibitors (SSRIs), helped relieve itching in clinical trials. Examples of SSRIs include paroxetine (Paxil) or fluoxetine (Prozac).

Drugs that inhibit the JAK2 gene and others are being studied.

Feb. 08, 2017
References
  1. Tefferi A. Diagnostic approach to the patient with polycythemia. http://www.uptodate.com/home. Accessed Nov. 16, 2016.
  2. Polycythemia vera. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/poly/. Accessed Nov. 16, 2016.
  3. Tefferi A. Prognosis and treatment of polycythemia vera. http://www.uptodate.com/home. Accessed Nov. 16, 2016.
  4. Polycythemia vera facts. Leukemia & Lymphoma Society. https://www.lls.org/llssearch?search-terms=polycythemia+vera&search_language=en. Accessed Nov. 16, 2016.
  5. Mesa RA, et al. Effect of ruxolitinib therapy on myelofibrosis-related symptoms and other patient-reported outcomes in COMFORT-I: A randomized, double-blind, placebo-controlled trial. Journal of Clinical Oncology. 2013;31:1285.
  6. Brian JC, et al. Overcoming treatment challenges in myelofibrosis and polycythemia vera: The role of ruxolitinib. Cancer Chemotherapy and Pharmacology. 2016;77:1125.
  7. Geyer H, et al. Symptomatic profiles of patients with polycythemia vera: Implications of inadequately controlled disease. Journal of Clinical Oncology. 2016;34:151.
  8. Polycythemia vera. Merck Manual Professional Version. http://www.merckmanuals.com/professional/hematology-and-oncology/myeloproliferative-disorders/polycythemia-vera. Accessed Nov. 16, 2016.