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Some polycythemia vera (PV) patients have further disease progression despite treatment. After years of disease, several conditions may arise:

  • Cells can undergo further changes and no longer overproduce red cells. For a time, the red cell count may stay near normal without treatment or drop below normal, resulting in anemia.
  • The spleen may become further enlarged.
  • Bone marrow may become fibrous or scarred, reducing its ability to make red cells and platelets, a condition called myelofibrosis.
  • The platelet count may fall to low levels.
  • Immature white cells may be released from the marrow into the blood.

Therapy at this time may include:

  • blood transfusions as needed for anemia and pain control
  • myelosuppressive drugs to control white cell and platelet counts or spleen size
  • splenectomy (surgical removal of the spleen) for some cases of massive spleen enlargement
  • low-dose radiation therapy to the spleen for patients unable to tolerate surgery
last updated on Thursday, June 28, 2012
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