Polycythemia vera (PV) is a chronic form of non life-threatening blood cancer. There’s no cure, but that doesn’t mean you shouldn’t get treatment or don’t have options.
Read about why you shouldn’t delay treating your PV and what options are available to you.
Purpose of Treatment
The purpose of treatment is to control abnormal cell replication. This will help reduce the thickness of your blood, allowing you to get more oxygen. The more oxygen you get, the fewer symptoms you’re likely to experience.
Another goal of treatment is to reduce complications and side effects. This includes headaches and itchiness, which are caused by a blockage of blood flow.
Your hematologist, a specialist in blood diseases, will be the doctor in charge of your treatment. They will discuss your treatment options, which will take into account the stage of your disease, your age, your risk of blood clotting, and your level of tolerance.
When you’re properly treated, you’ll be able to live a productive life with PV for many years.
Treatment typically begins by taking aspirin along with phlebotomy, a procedure similar to a regular blood donation in which excess blood is removed and discarded from your body.
A daily, low-dose aspirin can help reduce your chance of blood clots. Regular phlebotomy can help reduce your body’s red blood cell volume and help stabilize your blood counts.
Drug Treatment Options
If your PV doesn’t respond well to an aspirin and phlebotomy regimen, your next option is prescription drugs.
Hydroxyurea is a prescription drug and will likely be the first course of action after initial treatment. It’s considered a mild form of chemotherapy. It limits the number of cells made by the bone marrow and is usually taken if you’re at higher risk than others for blood clots. Some common side effects of hydroxyurea include allergic reactions, low blood counts, infection, and others.
Interferon alpha is another drug, and is often prescribed to younger patients or women who are pregnant. This drug is injected with a needle, typically three times a week. It will prompt your body to lower your blood cell counts. One of the main disadvantages of this drug is its expensive price tag.
Jakafi (ruxolitinib) is a newer drug that was approved by the FDA in 2014 for those with advanced PV who are unable to tolerate hydroxyurea. As a JAK2 inhibitor, it stops action of the JAK2 mutation. About 95 percent of those with PV have the JAK2 gene mutation, which causes the uncontrolled reproduction of cells and the thickening of the blood.
More research is needed to determine the benefits of taking Jakafi earlier in the course of treatment for PV. Because it blocks the JAK2 gene mutation from signaling the cells to reproduce without control, it may be more readily used in the future.
Bone Marrow Transplants
One of the last or final treatment options is a bone marrow transplant. You may consider this option when your PV is advanced and all other treatments have been ineffective. You may also think about having a transplant if you experience serious bone marrow scarring and are no longer producing healthy, functioning blood cells.
After a successful bone marrow transplant, you will no longer have symptoms of PV. This is because the stem cells, where the disease originates, will be replaced.
However, complications from a bone marrow transplant can be serious. This includes rejection of the stem cells by your body and damage to your organs. Make sure to discuss having a bone marrow transplant thoroughly with your hematologist beforehand.
Future of PV Treatments
Because there’s no complete cure for PV, advances in research and treatments are ongoing.
The discovery of the JAK2 gene and its mutation was a huge step forward in the understanding of PV. A search for the cause of this mutation continues, and once it’s found, you may see even more advances in treatment options.
Clinical trials are another way in which new treatments are being evaluated and tested. Your hematologist may also speak with you about clinical trials if you’re at higher risk for blood clots.
No matter what course of treatment you and your hematologist decide is best, know that PV can be controlled and managed effectively.