Polycythemia Vera 1700035927

Polycythemia Vera
Presented By
Muhammad Younus
Medical Laboratory Technologist
What Is Polycythemia Vera?
Polycythemia vera (PV) is a blood cancer that

begins in the marrow of your bones, the soft
center where new blood cells grow. It causes
your marrow to make too many red blood cells
so your blood is too thick. You may be more
likely to have clots, a stroke, or a heart attack.
Continued…
This disease gets worse slowly, usually over

many years. It can be life-threatening if you
don't get treatment, but the right care can help
you live a long life.
Most people who have PV don’t get diagnosed
until they’re 60 or older, usually after a routine
blood test. But it can happen at any age. Men
get it more often than women.
Causes of Polycythemia Vera
Your bone marrow makes three types of blood

cells:
Red
White
Platelets
Continued…
Red blood cells carry oxygen, white ones fight infections,

and platelets clot your blood to stop bleeding.
Most people with polycythemia vera have too many red
blood cells. But it can also cause you to have too many
white blood cells and platelets.
PV is caused by a gene (either JAK2 or TET2) that doesn’t
work the way it should. Most likely, the problem
happened over the course of your life. Rarely, parents
can pass these faulty genes to children.
Polycythemia Vera Symptoms
At first, you may not notice any problems. When they do

show up, polycythemia vera symptoms can include:
 Headaches
 Double vision
 Dark or blind spots in your vision that come and go
 Itching all over your body, especially after you've been
in warm or hot water
 Sweating, especially at night
Continued…
A red face that looks like sunburn or blushing

Weakness
Dizziness
Weight loss
Shortness of breath
Tingling or burning in your hands or feet
Painful joint swelling
Continued…
You may also feel pressure or fullness below

your ribs on your left side. This might mean PV
has enlarged your spleen, an organ that helps
filter your blood.
Polycythemia Vera Complications
Blood clots can cause a heart attack, a stroke, or deep vein

thrombosis (DVT). They might also make your liver or spleen
larger. If your organs don’t get enough blood, you could
have chest pain or heart failure.
Having too many red blood cells might cause stomach
ulcers, gout, or kidney stones.
PV can also lead to more serious blood diseases like acute
leukemia or myelofibrosis. Acute leukemia is a blood
cancer that gets worse quickly. Myelofibrosis is a condition
in which your bone marrow fills with scar tissue.
Polycythemia Vera Diagnosis
Your doctor will start with a physical exam,

including a check of your spleen. They’ll ask
about your symptoms and see if your face is
unusually red.
Continued…
You may have some blood tests, including:

 Complete blood count(CBC). Your doctor takes a
sample of your blood and sends it to a lab, where a
machine counts the number of red blood cells, white
blood cells, and platelets. An unusually high number of
any of these could be a sign of polycythemia vera.
 Blood smear. Your doctor looks at a sample of your
blood through a microscope. It's a way to check for
other diseases that are sometimes linked to PV.
Continued…
EPO level. This test measures how much of the

hormone EPO is in your blood. EPO tells your
bone marrow to make blood cells. People who
have polycythemia vera have very low amounts
of it.
The normal range is 2.6 to 18.5 milliunits per
milliliter.
Bone Marrow Biopsy
Polycythemia Vera Treatment
If you don't have many symptoms, you might

not need treatment for PV right away. Your
doctor will keep a close watch on you.
If you do need treatment, it will be aimed at
lowering the amount of red blood cells your
body makes and preventing blood clots and
other complications.
Continued…
Your options include:

 Phlebotomy. This is often the first treatment for people
who have polycythemia vera.
 Your doctor takes blood from your vein so you have
fewer blood cells. It's a lot like donating blood. After it's
done, your blood will be thinner, and it’ll flow more
easily. You'll usually feel better, too. Some symptoms will
ease, like headaches or dizziness.
 Your doctor will decide how often you need phlebotomy.
Some people with PV don’t need any other treatment for
many years.
Continued…
 Low-dose aspirin. This keeps platelets from sticking

together. That makes you less likely to get blood clots,
which in turn makes heart attacks or strokes less likely.
Most people with polycythemia vera take low-dose
aspirin.
 Medicine to lower blood cells. If you need more help,
your doctor may
prescribe hydroxyurea (Droxia, Hydrea), a pill that
lowers your red blood count and eases symptoms.
Continued…
Another drug, interferon alfa (Intron A), helps

your immune system cut back on making blood
cells. You might take busulfan (Busulfex, Myleran)
or ruxolitinib (Jakafi) if hydroxyurea isn’t helpful
or if it causes severe side effects.
If you have itching that doesn't go away, your
doctor may give you antihistamines.
Lifestyle Changes
 Don't smoke or chew tobacco. Tobacco narrows blood

vessels, which can make blood clots more likely.
 Get light exercise, such as walking, to help your
circulation and keep your heart healthy.
 Do leg and ankle exercises to keep clots from forming in
the veins of your legs. Your doctor or a physical therapist
can show you how.
 Bathe or shower in cool water if warm water makes you
itch.
 Keep your skin moist with lotion, and try not to scratch.
Polycythemia Vera Prognosis
There's no cure, but the right treatment can help

you manage this disease for many years.

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Polycythemia Vera

Polycythemia vera (PV) is a blood cancer that

This disease gets worse slowly, usually over

Your bone marrow makes three types of blood

Red blood cells carry oxygen, white ones fight infections,

At first, you may not notice any problems. When they do

A red face that looks like sunburn or blushing

You may also feel pressure or fullness below

Blood clots can cause a heart attack, a stroke, or deep vein

Your doctor will start with a physical exam,

You may have some blood tests, including:

EPO level. This test measures how much of the

If you don't have many symptoms, you might

Your options include:

 Low-dose aspirin. This keeps platelets from sticking

Another drug, interferon alfa (Intron A), helps

 Don't smoke or chew tobacco. Tobacco narrows blood

There's no cure, but the right treatment can help

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