Polycythemia vera (PV) is a type of slow-growing blood cancer that causes excess red blood cell production. It can also increase the amount of white blood cells and platelets in the blood. The extra cells make the blood thicker and more likely to clot.
PV increases the risk of acute myeloid leukemia, myelofibrosis, and myelodysplastic syndromes. These are rare but potentially serious complications.
There is no cure for PV, but treatments are available to manage symptoms and thin the blood. This helps reduce the risk of a clot or other complications.
PV is often discovered through routine blood work. Common symptoms include fatigue, dizziness, headaches, and itchy skin. Blood work that shows high levels of red or white blood cells and platelets could mean PV.
PV treatment helps to manage symptoms and reduce the risk of a major clot. Untreated PV results in thicker blood that is more likely to clot. It also increases the risk of developing other types of blood cancers. Typical treatments for PV include:
- Phlebotomy. This is when some blood is removed to thin it and reduce the risk of a clot.
- Blood thinners. Many people with PV take a low dose aspirin daily to thin the blood.
- Medications to lower blood cell and platelet concentration. There are different options available depending on your medical history and blood levels.
- Medications to manage itchy skin. Antihistamines or antidepressants are often used. Some drugs used to lower the amount of blood cells and platelets in PV also help relieve itchy skin.
If you have PV, your blood levels and symptoms will need to be closely monitored. Even with careful monitoring and care, PV can sometimes progress. It’s a good idea to keep in regular contact with your healthcare team. If there are changes with your blood levels or how you’re feeling, your treatment plan may change as needed.
Cells that overproduce blood cells can wear out. This causes scar tissue and possible progression to myelofibrosis (MF). In some cases, the spleen gets enlarged after years of filtering excess blood cells. The progression to leukemia and myelodysplastic syndromes is rare but can occur.
Myelofibrosis (MF) is another rare type of cancer that affects the blood and bone marrow. It tends to be slow growing.
With MF, scar tissue builds up in the bone marrow. Healthy cell production is blocked by cancer cells and scar tissue. The result is lower levels of white and red blood cells and platelets.
MF develops gradually so symptoms may not occur in early stages. Blood work may show that levels of blood cells are changing. If so, further investigations are needed. Other tests, including a bone marrow biopsy, may be done to confirm the diagnosis.
Lower levels of healthy blood cells are seen in both MF and leukemia. Because of this, they have similar signs and symptoms. Signs and symptoms of myelofibrosis include:
- low levels of red and white blood cells and platelets
- fatigue or low energy
- unexplained weight loss
- night sweats
Because MF tends to grow slowly, many people with this condition won’t need treatment right away. Close monitoring is important to watch for any changes in blood levels or symptoms. If treatment is recommended, it may include:
- Stem cell transplantation. An infusion of donor stem cells can help increase the amounts of red and white blood cells and platelets. This treatment typically involves chemotherapy or radiation before the transplant. Not everyone with myelofibrosis is a good candidate for a stem cell transplant.
- Ruxolitinib (Jakafi, Jakarta) or fedratinib (Inrebic). These medications are used to manage symptoms and help normalize blood cell levels.
Myelodysplastic syndromes (MDS) are a type of cancer that occurs when the bone marrow makes abnormal blood cells, affecting the production of red and white blood cells and platelets. These damaged cells don’t function properly and crowd out healthy cells.
There are many different types of MDS. It can be fast or slow growing. MDS can progress to acute myeloid leukemia, which is a much faster-growing type of cancer than MDS.
MDS has similar signs and symptoms to other types of blood cancer. Slow-growing types of MDS may not have many symptoms. Blood work would start to show changes in blood cell levels.
Signs and symptoms of MDS can include:
- tiring easily
- feeling generally unwell
- frequent infections
- bruising or bleeding easily
There are many different forms of MDS. The treatment your doctor prescribes will depend on the type of MDS and your personal health history. Treatments for MDS include:
- Monitoring. Some people with MDS may not need treatment right away. Their symptoms and blood levels will be regularly monitored for any changes.
- Blood transfusions. Red blood cells and platelets can be given by infusion. This helps increase levels in the body to treat anemia and help blood to clot properly.
- Growth factor agents. These medications help the body make more healthy blood cells and platelets. They are given by injection. They don’t work for everyone, but many people with MDS do see an improvement in blood levels.
- Chemotherapy. There are several chemotherapy drugs used for MDS. If the type of MDS is at risk or progressing quickly, a more intense type of chemotherapy will be used.
- Stem cell transplantation. This treatment isn’t recommended for everyone because there can be serious risks. It involves the infusion of donor stem cells. The plan is for donor stem cells to grow into new healthy blood cells.
Leukemia is another type of blood cancer that occurs when a stem cell in the bone marrow becomes abnormal. This triggers the creation of other abnormal cells. These abnormal cells grow faster than normal healthy cells and start to take over. A person with leukemia has lower levels of normal white and red blood cells and platelets.
There are different types of leukemia. Having PV increases your risk of a type called acute myeloid leukemia (AML). AML is the most common form of leukemia in adults.
Leukemia lowers levels of red blood cells, white blood cells, and platelets in the body. People with AML have very low levels of these. This puts them at risk of anemia, infections, and bleeding.
AML is a fast-growing type of cancer. There will likely be symptoms present along with lower blood cell counts. Typical symptoms of leukemia include:
- feeling short of breath
- frequent infections
- unexplained weight loss
- loss of appetite
- bruising more easily
There are different treatment options for leukemia. The goal of treatment is to kill cancer cells to allow new and healthy blood cells and platelets to form. Treatments typically include:
- Chemotherapy. There are many different chemotherapy medications available. Your healthcare team will determine the best approach for you.
- Stem cell transplantation. This is typically done along with chemotherapy. The hope is for the new transplanted stem cells to grow into healthy blood cells.
- Blood transfusions. Low levels of red blood cells and platelets can cause anemia and excess bleeding or bruising. Red blood cells carry iron and oxygen around the body. Anemia can make you feel very fatigued and low energy. People with AML may get red blood cell and platelet transfusions to boost their levels.
PV is a type of blood cancer that causes higher than normal levels of blood cells. Thicker blood is more likely to clot so treatment is necessary. In rare cases, PV can progress to other types of blood cancers.
There are different treatment options available to help manage symptoms and keep the disease from worsening. Keep your healthcare team up to date on how you are feeling. Regular blood work and appointments will help determine the best care plan for you.