What are treatment options for polycythemia vera (PV)?

Updated: Sep 20, 2021
  • Author: Srikanth Nagalla, MD, MS, FACP; Chief Editor: Sara J Grethlein, MD, FACP  more...
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Treatment measures are as follows:

  • Phlebotomy – To keep hematocrit below 45%

  • Aspirin – 81 mg daily

  • Cytoreductive therapy – For patients at high risk for thrombosis

  • Splenectomy in patients with painful splenomegaly or repeated episodes of splenic infarction

Hydroxyurea is the most commonly used cytoreductive agent. If hydroxyurea is not effective or not tolerated, alternatives include the following:

  • Interferon alfa

  • Busulfan – In patients older than 65 years

  • Ruxolitinib (Jakafi)

For discussion of polycythemia in children, see Pediatric Polycythemia vera.

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