Tx of pol - pacemaker

[ArchivalUser]

polycythemia vera if platelets count is increased

phlebotomy or hydroxyurea or both

[ArchivalUser]

both

[ArchivalUser]

hydroxyurea is preferred.

[ArchivalUser]

phlebotomy,if more frequent needed then hydroxyurea

[ArchivalUser]

A major cause of morbidity in patients with polycythemia vera is thrombosis, which can be alleviated by lowering the hematocrit to <45% with phlebotomy or by administering hydroxyurea. Patients with polycythemia vera may also have a mildly increased leukocyte or platelet count; treatment with hydroxyurea, which lowers counts of all three hematopoietic cell lines, would be preferable to phlebotomy if the patient's platelet count were increased to >600,000/μL (600 × 109/L). The addition of low-dose aspirin has been shown to reduce thrombotic complications in polycythemia vera and should be administered in the absence of contraindications. Although phlebotomy would lower the patient's hematocrit and anagrelide can be administered to lower the platelet count, low-dose aspirin would still be a necessary component of treatment. The administration of oral iron supplementation may further increase the patient's hematocrit and increase the risk for a thrombotic complication. The use of low-dose aspirin is preferred to aspirin at a dose of 325 mg/d to prevent thrombotic complications in patients with polycythemia vera who paradoxically are also at increased risk for developing hemorrhagic complications.



treatment with hydroxyurea, which lowers counts of all three hematopoietic cell lines, would be preferable to phlebotomy if the patient's platelet count were increased to >600,000/μL (600 × 109/L).