Polycythemia Vera

1 What is Polycythemia Vera?

A slow-growing type of blood cancer when your bone marrow makes too much red blood cells is called polycythemia vera that can also result in too many white blood cells and platelets. The excess cells make your blood thick and can cause complications such as bleeding or blood clots.

This disorder is not common, you might have it for years without even noticing it, sometimes it can be found in a blood test for other conditions and this can be fatal if left untreated.

It can also lead to serious blood cancers such as acute leukemia or myelofibrosis.

2 Symptoms

Some of the possible signs and symptoms of polycythemia vera include:

Because this disorder can cause blood clots in your head, it can lead to stroke. Consult your doctor if you have the signs and symptoms of a stroke such as:

  • sudden paralysis,
  • weakness and numbness of your face, leg or arm, mostly on one side of your body,
  • sudden blurred, decreased or double vision; sudden difficulty speaking or understanding speech (aphasia),
  • a sudden and severe headache that can be accompanied by facial pain, stiff neck, vomiting, pain between your eyes,
  • problems with memory, spatial orientation or perception and confusion,
  • loss of balance or coordination,
  • sudden dizziness.
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3 Causes

When a mutation in a bone marrow cell causes a problem with blood cell production, polycythemia vera occurs. The mechanism your body uses to control the production of blood cells becomes damaged that your bone marrow has to make too many of some blood cells.

A mutation in the protein JAK2 (JAK2 V617F) occurs in most people with polycythemia vera but there are also other mutations not yet known.

The cause of this mutation is unclear but researchers believe that it is acquired or occurs after conception.

4 Making a Diagnosis

Consult your primary doctor if you have the signs and symptoms of polycythemia vera and he may refer you to a hematologist to receive a diagnosis. Ask your doctor if you need to do something before the appointment. Bring a family member or a close friend to accompany you and support you. On a notebook, write down the symptoms that you are experiencing and the recent changes or major stresses in your life. You can also write down the medications, supplements and vitamins that you are taking.

Some of the questions that you can ask your doctor include:

  • what is the cause of my symptoms?
  • Is this temporary or long lasting?
  • What tests do I need?
  • What treatments do you recommend?
  • What websites do you recommend?
  • Do I need follow-up visits?
  • Your doctor will also ask you questions such as:
  • When did first begin experiencing the symptoms?
  • Are they occasional or continuous?
  • How severe are they?

It is possible that your doctor might recommend blood test, if this happens your blood test may reveal:

  • elevated hematocrit measurement – the percentage of red blood cells which makes up the total blood volume,
  • an increase in the number of red blood cells – or in white blood cells or platelets,
  • very low levels of erythropoietin – hormone that stimulates bone marrow to produce new red blood cells,
  • elevated levels of hemoglobin – iron-rich protein in red blood cells.

Your doctor may recommend a biopsy – taking a sample of solid bone marrow material or bone marrow aspiration – withdrawing a sample of the liquid portion of your bone marrow. You may have polycythemia vera if it shows that it is producing higher than normal blood cells. It may also show the mutation in the cells (JAK2 V617F).

5 Treatment

There is no cure for polycythemia vera but the treatment mainly focuses on reducing the amount of blood cells in your body and to prevent complications.

Some of the possible treatments are:

  • taking a low dose of aspirin to reduce the burning pain and to risk of blood clots,
  • taking blood out of your veins in a procedure called phlebotomy to decrease your blood volume, this procedure will depend on the severity of your condition,
  • medications such as hydroxyurea (Droxia, Hydrea) to help in suppressing your bone marrow’s ability to produce blood cells,
  • therapy to reduce the feeling of itch such as medication like antihistamine or SSRIs or an ultraviolet light treatment for relief.

6 Prevention

Polycythemia vera cannot be prevented but you can prevent or delay symptoms and complications with proper treatment.

7 Alternative and Homeopathic Remedies

There are no homeopathic remedies for polycythemia vera.

8 Lifestyle and Coping

Try some of these helpful lifestyle measures in order to cope with polycythemia vera:

  • exercise regularly because it will improve your blood flow leading to decrease of risk in having blood clots such as ankle and leg stretches and walking,
  • avoid tobacco because it can make your blood vessels narrow which can lead to stroke or heart attack,
  • take care of your skin by bathing in cool water to reduce the itching and by controlling yourself in scratching because you can have infection just by scratching, use lotion to keep your skin moist and avoid hot tubs and warm baths,
  • watch out for sores in your feet and hands; avoid extreme temperatures to reduce the risk of poor blood flow.

9 Risks and Complications

There are several risks and complications associated with polycythemia vera.

The risk of polycythemia vera increases with age and it is more common in people who are older than 60.

Some of the possible complications include:

  • blood clots – it can slow the rate of blood flow in your arteries and veins. Abnormalities in your platelets can also increase your risk in blood clots and this can lead to heart attack or stroke or pulmonary embolism or a deep vein thrombosis,
  • skin problems – this can occur mostly after warm bath or sleeoing in a warm bed that you may feel tingling or burning sensation, your skin may also appear red,
  • enlarged spleen or splenomegaly – this might happen because of polycythemia,
  • other blood disorders – such as myelofibrosis in which bone marrow is replaced with scar tissue, acute leukemia which is the cancer of the bone marrow and blood, or myelodysplastic syndrome in which stem cells don’t mature,
  • a lot of red blood cells can cause complications such as peptic ulcers or gout.
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