From the Research
Introduction to Polycythemia Vera
Polycythemia Vera (PV) is a myeloproliferative neoplasm characterized by an increased red blood cell mass and an increased risk of thrombosis, as noted in studies such as 1.
Complete Blood Count (CBC) Results in Polycythemia Vera
The CBC results in PV typically show erythrocytosis, which is an increase in red blood cell mass, as well as thrombocytosis and leukocytosis in some cases, as discussed in 1 and 2.
Key Features of CBC Results
- Erythrocytosis, indicated by elevated hemoglobin and hematocrit levels, is a hallmark of PV, with hemoglobin levels often greater than 16.5 g/dL in men and 16 g/dL in women, and hematocrit levels greater than 49% in men and 48% in women, as mentioned in 3 and 2.
- Thrombocytosis, or an elevated platelet count, is present in approximately 53% of patients, as noted in 1.
- Leukocytosis, or an elevated white blood cell count, is present in approximately 49% of patients, as mentioned in 1.
Diagnosis and Treatment
The diagnosis of PV is based on the presence of a JAK2 gene variant, as well as clinical and laboratory features such as erythrocytosis, thrombocytosis, and leukocytosis, as discussed in 1 and 2.
Treatment Options
- Therapeutic phlebotomy, with a goal hematocrit of less than 45%, is a mainstay of treatment, as mentioned in 1 and 2.
- Low-dose aspirin, typically 81 mg daily, is also recommended for all patients, unless contraindicated, as noted in 1 and 2.
- Cytoreductive therapy, such as hydroxyurea or interferon, may be used in patients at high risk of thrombosis, as discussed in 1, 4, and 2.
- Ruxolitinib, a Janus kinase inhibitor, may be used in patients who are intolerant of or resistant to hydroxyurea, as mentioned in 1 and 2.
Differential Diagnosis and Caveats
It is essential to distinguish PV from other causes of erythrocytosis, such as secondary erythrocytosis due to tobacco smoking or sleep apnea, as noted in 1.
Important Considerations
- The presence of a JAK2 gene variant is a key factor in distinguishing PV from other causes of erythrocytosis, as discussed in 1 and 2.
- Patients with PV are at increased risk of thrombosis, myelofibrosis, and acute myeloid leukemia, as mentioned in 1 and 2.
- Regular monitoring of CBC results and clinical features is crucial in managing PV and preventing complications, as noted in 1 and 2.