The goal of treatment is to control symptoms and reduce the risk of complications, especially heart attack and stroke. Treatment methods depending on general condition, age and symptoms include. If there is a significant increase in the white blood cell count or if uric acid is 10 mg. or more, Allopurinol is prescribed. Thrombocytosis causing ocular migraine, transient ischemic attacks, or erythromelalgia that does not respond to aspirin will also require platelet count reduction, but only to the extent that symptoms are relieved.
Although low-dose aspirin is recommended for polycythemia, there is insufficient data to support its use as prophylaxis against anything other than microvascular complications such as ocular migraine or erythromelalgia. There is also no evidence to support the recommended use of hydroxyurea in patients over 65 years of age or in patients at high risk for a thrombotic event, as hydroxyurea has not been found to be effective in preventing arterial or venous thrombosis in these potentially high-risk patients.
Polycythemia vera can cause itching throughout the body. It is important not to damage the skin when combing. If you experience severe itching while swimming or showering, try using cool water and a gentle soap. Dry your skin thoroughly and gently after bathing and apply moisturizing lotion to your skin. Starch baths can also help relieve itchy skin. But if the condition is more serious, drug treatment is used. Modern therapy starts with an antihistamine or advair diskus treatment (Doxepin), and, if this does not help, moving on to hydroxyurea if symptoms are acute, or PUVA light therapy, or pegylated Alpha Interferon, or Unmodified Alpha Interferon.
Hydroxyurea or Interferon-alpha is given to prevent the bone marrow from producing too many red blood cells.
In some cases, Anagrelide is prescribed if tolerated, as it is as effective as hydroxyurea in reducing the number oftwo platelets. People at high risk of developing blood clots (age over 60 years, history of blood clot) need additional therapy. Often the first drug added to therapeutic phlebotomy is oral hydroxyurea. It is an oral chemotherapy drug that reduces the production of red blood cells in the bone marrow and also reduces the production of fluticasone and platelets. Similar to other conditions treated with hydroxyurea, it is started at a low dose and increased until the hematocrit is in the target range.
The drug is generally well tolerated with few side effects other than decreased blood cell production. Other side effects include mouth sores, hyperpigmentation (dark changes in skin color), rash, and nail changes (dark lines under the nails). Low dose Aspirin is also considered a successful treatment. The medicine weakens the ability of platelets to stick together, thereby reducing the development of blood clots. Aspirin should not be used if there is a history of heavy bleeding.
For people who experience uncontrollable itching (itching), women who are pregnant or in childbearing age, or who are refractory to previous treatments, Interferon Alpha, a subcutaneous infection that reduces the number of red blood cells, may be used. In addition, it can also reduce spleen size and itching. Side effects include fever, weakness, nausea, and vomiting, which limit the usefulness of this medication.
If for some reason treatment with Hydroxyurea and/or Interferon Alpha is not possible, the chemotherapy drug Busulfan can be used. The dose is adjusted to maintain white blood cell and platelet counts within an acceptable range. Another drug used in current treatments for patients who have failed the above treatments is Ruxolitinib. This medication inhibits the Janus Associated Kinase (JAK) enzyme, which is often affected in polycythemia and other myeloproliferative neoplasms. It is often used for people who develop post-polycythemia and myelofibrosis. And may also be useful for severe symptoms and an enlarged spleen. Modern methods of treating serious complications.