Diagnosis and Treatment of PV
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:
- Watch & Wait: People with no symptoms are generally not treated at the time of diagnosis. Some people remain stable and symptom free for many years. It is very important for anyone who has been diagnosed with polycythermia vera to be closely monitored through regular medical check-ups to look for any signs or symptoms of disease progression.
- 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.
- JAK Inhibitors: new kinds of drugs that focus on fixing a genetic problem that has been linked to polycythemia vera.
- Chemotherapeutic drugs, which may reduce the platelet count, are usually given by mouth (orally). Some drugs may be given through a vein.
- Aspirin, taken orally in low doses, can help reduce the risk of clotting.
- Biological therapies, which may help reduce platelet counts, are usually given by injection.
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.