Bleeding due to von Willebrand disease.
Epsilon-aminocaproic acid (Amicar) is an effective treatment for patients with bleeding due to acquired von Willebrand disease until the platelet count decreases. Apheresis for extreme thrombocytosis cannot be recommended except in rare cases in a very acute situation, as it is not effective for extreme thrombocytosis and rapid platelet count recovery.
An enlarged spleen is the most challenging complication of polycythemia because it is usually resistant to buy allegra drug and does not improve in the long term with radiation. The pathology is associated with a high morbidity rate due to postoperative splenic vein thrombosis or intra-abdominal hemorrhage, leukocytosis or thrombocytosis.
Acute leukemia, regardless of etiology, usually has a rapid clinical course that does not respond to treatments effective for primary acute myeloid leukemia. Pulmonary hypertension is a common complication in this setting, along with anorexia, weight loss, night sweats, and anemia. If left untreated, this form of the disease has an inexorable course and leads to a shortened life expectancy.
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Myelofibrosis is considered a complication of the disease, but in fact it is a reversible reactive process, and the real problem is hematopoietic stem cell deficiency. If not recognized and treated early, bone marrow failure will lead to permanenttolerance to interferon or other forms of cytoreductive therapy. This is also a situation where new nonspecific JAK2 inhibitors should be useful in relieving constitutional symptoms, reducing spleen size, and preventing potentially leukemogenic drugs.
Polycythemia vera and life expectancy. Polycythemia is not a monolithic disorder and in most patients has a very slow clinical course with a progressive increase in blood counts and an increase in the size of the spleen. However, the disease requires periodic phlebotomy and attention to certain problems, such as itching or Fexofenadine drug. This is because the load on the stem cells increases very slowly and they continue to function for many years. However, in a small proportion of patients, the disease progresses more aggressively and with complications that can also affect other organs, including bone marrow fibrosis, thereby reducing overall life expectancy.
In patients who do not receive any treatment, death occurs several months (maximum a year and a half) after diagnosis due to bleeding or thrombosis. With treatment, life expectancy with polycythemia vera reaches 10 years or more. The disease progresses to myelofibrosis in 30% of cases and to AML in 5% - and these disorders have a worse prognosis.
To date, only bone marrow transplantation has the potential to cure polycythemia, but all other current treatments should be considered supportive. However, given the morbidity and mortality associated with allogeneic bone marrow transplantation, relative to the life expectancy of most patients with polycythemia, this procedure cannot be routinely recommended, and certainly is not suitable for many due to their age or is not available due to lack of a suitable donor .
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Polycythemia vera (erythremia, Vaquez disease or primary polycythemia) is a progressive malignant disease belonging to the group of leukemias, which is associated with hyperplasia of the cellular elements of the bone marrow (myeloproliferation). The pathological process primarily affects the erythroblastic germ, so an excess number of red blood cells is detected in the blood. An increase in the number of neutrophilic leukocytes and platelets is also observed.