URL of this page: http://www.nlm.nih.gov/medlineplus/ency/article/000589.htm
Alternative names
Primary polycythemia; Polycythemia rubra vera; Myeloproliferative disorder; Erythremia; Splenomegalic polycythemia; Vaquez's disease; Osler's disease; Polycythemia with chronic cyanosis - Myelopathic polycythemia; Erythrocytosis megalosplenica; Cryptogenic polycythemiaDefinition
Polycythemia vera is an abnormal increase in blood cells (primarily red blood cells) due to excess production of the cells by the bone marrow.
Causes, incidence, and risk factors
Polycythemia vera is an acquired disorder of the bone marrow that causes the overproduction of white blood cells, red blood cells, and platelets.
It is a rare disease that occurs more frequently in men than women, and rarely in patients under age 40. The exact cause is unknown.
Symptoms
Note: Symptoms are due to increased blood thickness and clotting.
Additional symptoms that may be associated with this disease:
Signs and tests
The health care provider will perform a physical exam. Tests that may be done include:
This disease may also alter the results of the following tests:
Treatment
The goal of treatment is to reduce the thickness of the blood and to prevent bleeding and clotting.
A method called phlebotomy is used to decrease blood thickness. One pint of blood is removed weekly until the hematocrit level is less than 45, then therapy is continued as needed.
Occasionally, chemotherapy (specifically hydroxyurea) may be given to suppress the bone marrow. Interferon may be given to lower blood counts. A medicine called anegrelide may be given to lower platelet counts.
The use of blood thinners (such as aspirin) is controversial because it may cause stomach bleeding.
Expectations (prognosis)
The disease usually develops slowly, and most patients do not experience any problems related to the disease after being diagnosed. However, the abnormal bone marrow cells may begin to grow uncontrollably in some patients leading to acute myelogenous leukemia. This occurs in a minority of cases.
Patients with polycythemia vera also have an increased tendency to form blood clots that can result in strokes or heart attacks. Some patients may experience abnormal bleeding because their platelets are abnormal.
Complications
Calling your health care provider
Call your health care provider if symptoms of polycythemia vera develop.
Update Date: 8/28/2007 Updated by: Stephen Grund, M.D. Ph.D., Chief of Hematology/Oncology and Director of the George Bray Cancer Center at New Britain General Hospital, New Britain, CT. Review provided by VeriMed Healthcare Network.