How Is Polycythemia Vera Treated?
Your doctor may treat your polycythemia vera (PV)
with a number of methods, either separate or in combination. Your treatment
options may include phlebotomy (fle-BOT-o-me), medicines, or biological
therapy.
Goals of Treatment
PV cannot be cured. The goals of treating PV are to
control your symptoms and reduce the risk of complications, especially
stroke or
heart
attack, caused by thickened blood and blood clots. This is done by reducing
the number of red blood cells and hemoglobin in your blood toward normal
levels. Reducing the number of red blood cells and hemoglobin brings the
thickness of your blood closer to normal levels. Blood with normal thickness
flows more easily through the arteries. This reduces the chances that blood
clots will form that could cause you to have a stroke or heart attack. Blood
with normal thickness delivers oxygen more efficiently to all parts of your
body. This can help reduce some of the signs and symptoms PV causes, such as
headaches, vision problems, and itching.
Studies show that treatment of PV greatly improves
your chances of living longer.
Specific Types of Treatment
Phlebotomy
In phlebotomy, your doctor or technician removes
some of your blood from a vein (similar to what is done when you donate blood).
A needle is inserted into your vein, and your blood flows through an airtight
tube into a sterile container or bag. This reduces the number of red blood
cells in your system and begins the process of bringing your blood thickness
closer to normal levels. Typically, a pint (1 unit) of blood is removed each
week until your hematocrit (the measure of what percentage of a tube of blood
consists of red blood cells) approaches a normal level. Then, you may continue
to have phlebotomy performed every few months as needed.
Medicines
Your doctor may prescribe medicines to keep your
bone marrow from making too many red blood cells. You may take hydroxyurea
(hi-DROK-se-u-RE-ah), a chemotherapy medicine, to reduce the numbers of red
blood cells and platelets in your blood. By limiting or reducing the number of
red blood cells in your blood, this medicine helps bring your blood thickness
and blood flow closer to normal levels.
Your doctor may advise you to take aspirin to
relieve bone pain and the burning sensation in hands or feet that you may
experience as a result of PV. Aspirin also reduces the chance of blood
clots.
Biological Therapy (Immunotherapy)
This form of treatment uses substances made
naturally in the body to stimulate your immune response against overproduction
of red blood cells. Your doctor may prescribe substances that your body
normally produces, like interferon-alpha, if you have PV. These substances
reduce the overproduction of blood cells by the bone marrow. This helps keep
your blood thickness and blood flow closer to normal levels, reduces the
chances of blood clots, and may reduce some of the signs and symptoms of
PV.
Other Types of Treatment
If you have itching as a result of PV, your doctor
may prescribe a number of prescription medicines to ease the discomfort you
feel. These include cholestyramine, cyproheptadine, cimetidine, or psoralen.
Your doctor also may prescribe ultraviolet light treatment and antihistamines
to help relieve your itching.
Your doctor may prescribe allopurinol if the level
of uric acid in your blood is higher than normal.
Your doctor may decide to treat you with radioactive
phosphorus (P32) to suppress overactive bone marrow cells. This
helps reduce the number of red blood cells in your blood, and keeps your
blood's thickness and flow closer to normal levels. |