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Treatment Option Overview for PV
Source: Myeloproliferative Neoplasms Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: September 27, 2024 · Captured 2026-09-09.
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Context: Treatment of Polycythemia Vera
The primary therapy for PV includes the use of phlebotomy or cytoreductive therapy to maintain the hematocrit below 45%. This approach was confirmed in a randomized prospective trial, which demonstrated lower rates of cardiovascular death and major thrombosis using this hematocrit target.[7]
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Complications of phlebotomy include:
Thrombocytosis and symptoms related to chronic iron deficiency, including pica, angular stomatitis, and glossitis.
Dysphagia resulting from esophageal webs (very rare).
Potential muscle weakness.
In addition, progressive splenomegaly and pruritus not controllable by antihistamines may persist despite control of the hematocrit by phlebotomy. For more information, see Pruritus.
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If symptoms persist or phlebotomy is not tolerated, cytoreductive therapy can be added to control the disease.
Guidelines based on anecdotal reports have been developed for the management of pregnant patients with PV.[8]
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Preserved source evidence · Not medical advice