Polycythemia vera

Description

Polycythemia vera (pol-e-sy-THEE-me-uh VEER-uh) is a type of cancer of the blood. This causes the bone marrow to produce red blood cells. These extra cells thicken your blood, slowing its flow. This can cause serious problems, such as blood clots.

Polycythemia vera is a rare. It comes on slowly. You could have it for years without knowing it. Often the condition is found during a blood test done for another reason.

Without treatment, polycythemia vera can be life-threatening. But with proper medical care can help alleviate the symptoms and complications of this disease.

Symptoms

Many people with polycythemia vera not notice the symptoms. Some people have symptoms such as headache, dizziness, tiredness and blurred vision.

Clear symptoms of polycythemia vera are:

  • Itching, especially after a hot bath or shower.
  • Numbness, tingling, burning, or weakness in the hands, feet, arms, or legs.
  • A feeling of fullness soon after you eat.
  • Swelling, or pain in the upper left of the abdomen due to an enlarged spleen.
  • Unusual bleeding, such as nosebleeds or bleeding gums.
  • Painful swelling of one joint, often the big toe of the foot.
  • The shortness of breath and difficulty breathing when lying down.
  • Pain in the bones.

When to see a doctor

Make an appointment with your healthcare professional the prprofessional if you have symptoms of polycythemia vera.

Causes

Polycythemia vera occurs when a change in a gene that causes a problem with the manufacture of blood cells. The body normally controls the number of each of the three types of blood cells. These are red blood cells, white blood cells, and platelets. But in polycythemia vera, the bone marrow produces too many of some of these blood cells.

The cause of the change in the gene in polycythemia vera is unknown. But does not pass through the families.

Risk factors

Polycythemia vera can occur at any age. But it is more common in adults over 60 years of age. Men are more likely to polycythemia vera than women.

Complications

The possible complications of polycythemia vera are:

  • The blood clots. The increase of the thickness of the blood, decreased blood flow and atypical platelets increase the risk of blood clots. Blood clots can cause a stroke or a heart attack. Or clots can block an artery in the lungs or in a deep vein of a muscle in the leg or in the womb.
  • Enlargement of the spleen. The spleen helps the body fight infection. Also the filters of waste, such as old or damaged blood cells. The extra blood cells that are produced with polycythemia vera, the spleen, the more hard work. What causes it to enlarge.
  • Problems due to high levels of red blood cells. Too many red blood cells can lead to other complications. These include open sores in the inner lining of the stomach, upper small intestine or esophagus, called peptic ulcers, and swelling of the joints, called the drop.
  • Other disorders of the blood. In rare cases, polycythemia vera can lead to other diseases of the blood. These include a disorder in which scar tissue replaces the bone marrow, a condition in which the stem cells do not mature or work as they should, and the cancer of the blood and bone marrow, called acute leukemia.

Polycythemia vera

Diagnosis

Your health care professional takes a medical history and perform a physical examination.

Blood tests

If you have polycythemia vera, blood tests may show:

  • More red blood cells than usual and, sometimes, an increase in the number of platelets or white blood cells.
  • A higher percentage of red blood cells that make up the total volume of blood, called a hematocrit measurement.
  • Highest level of the iron-rich protein in red blood cells that carries oxygen, called hemoglobin.

Bone marrow aspiration or biopsy

A healthcare professional suspects that you have polycythemia vera may suggest that you obtain a sample of the bone marrow, through a bone marrow aspiration or biopsy.

A bone marrow biopsy involves taking a sample of the spongy tissue in the bone marrow. A bone mar- row aspiration is often done at the same time to obtain a sample of the liquid portion of the cord.

Genetic testing

Study of the bone marrow or blood can show the change in the gene associated with the disease.

Treatment

There is No cure for polycythemia vera. The goal of treatment is to reduce the risk of complications. The treatments can also alleviate your symptoms.

The blood retreats

The most common treatment for polycythemia vera is to have blood removed often. This is done through a needle placed into a vein, called phlebotomy. It is the same procedure used for blood donation.

This reduces the volume of the blood, and reduces the number of excess of blood cells. How often you need to have blood withdrawal depends on the severity of your condition.

Treatments to reduce the itching

If the condition causes itchiness, medications such as antihistamines or treatments with ultraviolet light can give you relief.

The drugs used to treat depression called selective serotonin reuptake inhibitors (Ssris), helped to alleviate the itching in the clinical trials. Ssris include paroxetine (Brisdelle, Paxil) or fluoxetine (Prozac, Symbyax).

Medications that reduce the number of red blood cells

If the phlebotomy does not help enough, these medications can reduce the number of red blood cells in the blood:

  • Hydroxyurea (Droxia, Hydrea, Ifklos).
  • Interferon alfa-2b (Intron a).
  • Ruxolitinib (Jakafi).
  • Busulfan (Busulfex, Myleran).

Drugs for the heart

Your healthcare provider will also prescribe medications to control risk factors for heart disease, and vascular. These include high blood pressure, diabetes, and high cholesterol.

You could also take a low dose of aspirin to reduce the risk of blood clots. Low-dose aspirin may also help reduce the pain and burning in the feet or hands.

Self-care

Here are ways to feel better if you have polycythemia vera:

  • Exercise. Gentle exercise, such as walking, can improve the flow of blood. This helps to reduce the risk of blood clots. The leg and ankle stretches and exercises can also improve the flow of blood.
  • Do not use tobacco. The use of tobacco can constrict the blood vessels. This raises the risk of heart attack or stroke due to blood clots.
  • Do not go to places with low oxygen levels. Living at high altitudes, skiing or climbing in the mountains reduce the levels of oxygen in the blood.
  • Be good to your skin.To reduce the itching, bathe in cold water, use a mild cleanser and pat your skin dry. The addition of starch, such as corn starch, to your bath can help. Do not use hot tubs or heated hot tub. Do not take hot showers or baths. Try not to scratch. Scratching can damage your skin and increase the risk of infection. Use lotion on your skin to keep it moist.
  • Be careful in hot and cold temperatures.Poor circulation of the blood increases the risk of injury caused by heat and cold. In cold weather, always wear warm clothes. Keep feet and hands warm. Hot weather, protect you from the sun. Drink plenty of fluids.
  • See the sores. Poor blood circulation can make it difficult to you to heal the sores. Look at your hands and feet frequently. Tell your healthcare provider about any sores.

Be good to your skin. To reduce itching, bathe in cold water, use a mild cleanser and pat your skin dry. The addition of starch, such as corn starch, to your bath can help. Do not use hot tubs or heated hot tub. Do not take hot showers or baths.

Try not to scratch. Scratching can damage your skin and increase the risk of infection. Use lotion on your skin to keep it moist.

Be careful in hot and cold temperatures. Poor circulation of the blood increases the risk of injury caused by heat and cold. In cold weather, always wear warm clothes. Keep your feet and haveds hot.

In hot weather, protect you from the sun. Drink plenty of fluids.

Preparing for your appointment

It is likely to start by seeing your primary health care provider. If you have polycythemia vera, you may be sent to a specialist in blood conditions, called a hematologist.

Here's some information to help you prepare for your appointment.

What you can do

Make a list of:

  • All of your symptoms and when they began.
  • Key personal information, including to other medical conditions and family medical history.
  • All medications, vitamins or supplements that you are taking, including dosage and how often you take.
  • Questions to ask your health care professional.

For polycythemia vera, questions include:

  • What is the most likely cause of my symptoms?
  • What tests dor do I need to?
  • Is this condition goes away, or will I forever?
  • What treatments are available? What do you suggest?
  • I have other health conditions. How can I best manage them together?
  • You should see a specialist?
  • I need follow-up visits? If so, how often?
  • Are there brochures or other printed material I can have? What websites do you suggest?

Don't hesitate to ask other questions you have. Have a friend or family member, if possible, to help you remember the information they give you.

What to expect from your doctor

Your healthcare provider is likely to ask questions such as

  • Do you have symptoms all the time, or come and go?
  • How do your symptoms affect your life?
  • What, if anything, seems to improve your symptoms?
  • Anything that make your symptoms worse?
Symptoms and treatment of Polycythemia vera