Polycythemia Vera, April 15, 1998

Polycythemia Vera, April 15, 1998

This disease belongs to the group of myeloproliferative disorders, affecting stem cells and causing increases in all three blood cell lines—red, white, and platelets. Bone marrow examination shows hyperplasia of the entire bone marrow, contrasting sharply with aplastic anemia, where proliferation is impaired. Clinically, there is an increase in all three cell lines, along with hepatosplenomegaly, particularly pronounced in the red cell line. Red blood cell count, hemoglobin levels, hematocrit (HCT), and red cell distribution width (RDW) all rise; platelet counts and white blood cell counts also increase. Patients commonly present with facial flushing, headache, fatigue, skin itching, decreased vision, and numbness in the extremities. Treatment: Phosphorus-32 oral administration is preferred, at 2 curies twice daily, with each course lasting one week, followed by a one-week break before repeating. A small number of patients may benefit from busulfan or homoharringtonine.