Diagnosis and Treatment of Polycythemia Vera
Blood tests are used to diagnose polycythemia vera. Signs may include:
- An increase in red blood cells, platelets and white bloods cells
- A high hematocrit (the proportion of red blood cells in the blood)
- An increase in hemoglobin concentration (a protein found in red blood cells)
- Low levels of erythropoietin (a hormone that controls red blood cell production)
Additional tests may include:
- Bone marrow biopsy or aspiration to take a sample of bone marrow
- Testing for the presence of JAK2 mutation or other genetic mutations
Different health care providers involved in your care may include a hematologist/oncologist, a nurse, a nurse navigator, an oncology social worker or a pharmacist. These people can help you find information and resources that may be useful before, during and after treatment. Ask your doctor about the other members of your health care team – their names and how you can arrange to meet them. You also may want to ask your insurance company to assign you a case manager to help you understand which treatments and services your health insurance will cover.
Treatment choices depend on your diagnosis and the extent of the disease. The various drugs used to treat polycythemia vera work in different ways, and may have different side effects. Ask for more information before starting treatment. Your options may include:
- Aspirin, taken orally in low doses, can help reduce the risk of clotting, and is recommended for most PV patients
- Phlebotomy removes blood from a vein in order to lower the number of red blood cells in the body. This treatment is often used first.
- Cytoreductive therapies (e.g. hydroxyurea), which may reduce the blood counts, are usually given by mouth (orally).
- Inteferon alfa, which can lower blood counts, is given subcutaneously. Sustained release preparations (e.g. peginterferon alfa-2a), have superior tolerability.
- JAK Inhibitors: new kinds of drugs that focus on targeting a genetic problem that has been linked to polycythemia vera.
Other treatments may be available through clinical trials. Clinical trials can offer the opportunity to benefit from the latest treatments or combinations of treatments while helping advance knowledge of the disease and its treatment options. Ask your health care team if a clinical trial might be right for you.