Materiały źródłowe

• #1 Screening and Prevention of Polycythemia Vera | Hematology-Oncology Associates of CNY

  https://www.hoacny.com/patient-resources/blood-disorders/what-polycythemia-vera/screening-and-prevention-polycythemia-vera

  Primary polycythemia (polycythemia vera) can’t be prevented. However, with proper treatment, you can prevent or delay symptoms and complications. […] Sometimes you can prevent secondary polycythemia by avoiding things that deprive your body of oxygen for long periods. For example, you can avoid mountain climbing, living at a high altitude, or smoking. […] Following a healthy lifestyle to lower your risk of heart and lung diseases also will help you prevent secondary polycythemia.

• #2 A guideline for the management of specific situations in polycythaemia vera and secondary erythrocytosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6519221/

  Thrombotic events are the major cause of morbidity and mortality in PV, and their prevention is the main objective of treatment. […] Both primary and secondary prevention should include control of cardiovascular risk factors in accordance with current recommendations (NICE, 2014). […] In accordance with evidence for the management of PV, low-dose aspirin should be offered to all patients (Landolfi et al, 2004). […] Indefinite anticoagulation for VTE is recommended because of the presence of continuing risk (NICE 2012; Watson et al, 2015; Kearon et al, 2016). […] For unprovoked VTE, where there is no physical precipitating factor, we therefore recommend indefinite anticoagulation to reduce the incidence of recurrence. […] Patients should be screened for hypertension, hyperlipidaemia, diabetes mellitus and a smoking history. (GRADE 1B)

• #3 Polycythemia Vera: Barriers to and Strategies for Optimal Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10749566/

  Polycythemia vera (PV) is a subtype of myeloproliferative neoplasms characterized by impaired quality of life and severe complications. […] The therapeutic landscape has been revolutionized in recent years, where venesection and hydroxycarbamide associated with antiplatelet therapy have a central role and are now accompanied by other drugs, such as interferon and Janus kinase inhibitors. […] The current management of PV is based on risk stratification; hence, high-risk patients are defined as those aged 60-65 years old and/or the presence of PV-related TE. […] Cytoreductive therapy with VS and antiplatelets is recommended for this high-risk population, while low-risk patients are managed with just venesection and antiplatelets. […] It is well known that cardiovascular risk factors such as hypertension, hyperlipidemia, diabetes, or smoking habits can increase the risk of TE in the general population.

• #4 A guideline for the management of specific situations in polycythaemia vera and secondary erythrocytosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6519221/

  Cardiovascular risk should be assessed at baseline and annually using a validated score such as QRISK score. (GRADE 2C) […] Indefinite anticoagulation should be initiated for unprovoked venous thromboembolism dependent on bleeding risk. (GRADE 2C) […] Cytoreduction and venesection to keep haematocrit (Hct) 045. (GRADE 1A) […] Preoperative planning should involve a haematologist to optimise count control and individualise perioperative plan. (GRADE 1B) […] There should be close collaborative management between obstetrician and haematologist to formulate an individualised plan for the pregnancy, delivery and postpartum period based on the previous history of thrombosis, haemorrhage and previous pregnancies. (GRADE 1C) […] Avoid cytoreductive therapy (such as hydroxycarbamide and anagrelide) for a minimum of 3 months in male and female patients prior to planned conception and in the first trimester. Commence interferon if cytoreduction is required. (GRADE 1C)

• #5 Reducing Cardiovascular Risk in Patients With Polycythemia Vera

  https://www.ajmc.com/view/reducing-cardiovascular-risk-in-patients-with-polycythemia-vera

  Polycythemia vera (PV) therapy should aim to identify cardiovascular risk factors, according to one review. […] High blood pressure, smoking, and dyslipidemia are common in MPN and contribute to an increased risk of CV events, wrote the researchers of the study. Identifying patients at very high risk of fatal CV events is necessary to introduce early co-management by hematologists, cardiologists, and metabolic disease specialists. […] High CV risk individuals with modifiable risk factors, such as smoking, arterial hypertension, and dyslipidemia, were directed to either pharmaceutical management or lifestyle modifications. […] The ESC/European Society of Hypertension (ESH) 2018 guidelines recommend patients with PV and arterial hypertension should be treated with angiotensin-converting enzyme inhibitors (ACE-1) or angiotensin II receptor antagonists (ARB) with or without calcium channel blockers to obtain a blood pressure reduction to the target of less than 130/80 millimeters of mercury (mmHg).

• #6

  https://haematologica.org/article/view/4771

  Identifying the most safe and effective strategy for reducing the vascular risk of subjects with polycythemia vera and essential thrombocythemia has always been challenging. […] The presence of a myeloproliferative disorder should, however, increase efforts to identify and treat any additional risk factors and encourage the patient to adopt a healthy life-style. Particular attention should be given to smoking, which has an important effect on vascular risk and was found to be surprisingly common among polycythemia vera patients recruited in the ECLAP observational study. […] Successful changes in modifiable risk factors require full co-operation from the patient and this underlines the importance of sharing treatment decisions and goals with the patient. […] These recommendations do not include interventions on life style and all modifiable factors because these apply uniformly to all patients.

• #7 Reducing Cardiovascular Risk in Patients With Polycythemia Vera

  https://www.ajmc.com/view/reducing-cardiovascular-risk-in-patients-with-polycythemia-vera

  Similarly, ESC/European Atherosclerosis Society (EAS) recommend treatment of dyslipidemias with a target of 50% reduction low-density lipoprotein cholesterol (LDL-C) levels. However, lifestyle medications should be introduced as the first line of treatment, including diet, weight, and smoking factors. […] Lastly, in the prevention of thrombotic events, recommendations include prior cytoreductive therapy and anticoagulant therapy for individuals with PV and prior thrombotic events. In the case of no prior thrombotic events, treatment recommendations include a hematocrit (Ht) target of less than 45%, acetylsalicylic acid (ASA) of 40-100 mg per day, and cytoreductive therapy for high-risk PV. […] Strict control of CV risk factors, in association with appropriate hematological therapy, may improve outcomes of patients with Ph-MPN [Ph-positive MPN].

• #8 Reducing Cardiovascular Risk in Patients With Polycythemia Vera

  https://www.ajmc.com/view/reducing-cardiovascular-risk-in-patients-with-polycythemia-vera

  Similarly, ESC/European Atherosclerosis Society (EAS) recommend treatment of dyslipidemias with a target of 50% reduction low-density lipoprotein cholesterol (LDL-C) levels. However, lifestyle medications should be introduced as the first line of treatment, including diet, weight, and smoking factors. […] Lastly, in the prevention of thrombotic events, recommendations include prior cytoreductive therapy and anticoagulant therapy for individuals with PV and prior thrombotic events. In the case of no prior thrombotic events, treatment recommendations include a hematocrit (Ht) target of less than 45%, acetylsalicylic acid (ASA) of 40-100 mg per day, and cytoreductive therapy for high-risk PV. […] Strict control of CV risk factors, in association with appropriate hematological therapy, may improve outcomes of patients with Ph-MPN [Ph-positive MPN].

• #9 A guideline for the management of specific situations in polycythaemia vera and secondary erythrocytosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6519221/

  Thrombotic events are the major cause of morbidity and mortality in PV, and their prevention is the main objective of treatment. […] Both primary and secondary prevention should include control of cardiovascular risk factors in accordance with current recommendations (NICE, 2014). […] In accordance with evidence for the management of PV, low-dose aspirin should be offered to all patients (Landolfi et al, 2004). […] Indefinite anticoagulation for VTE is recommended because of the presence of continuing risk (NICE 2012; Watson et al, 2015; Kearon et al, 2016). […] For unprovoked VTE, where there is no physical precipitating factor, we therefore recommend indefinite anticoagulation to reduce the incidence of recurrence. […] Patients should be screened for hypertension, hyperlipidaemia, diabetes mellitus and a smoking history. (GRADE 1B)

• #10 What Is Polycythemia Vera? Symptoms, Causes, Diagnosis, and Treatment

  https://www.everydayhealth.com/blood-disorders/polycythemia-vera/guide/

  Can You Prevent Polycythemia Vera? […] Theres no way to prevent polycythemia vera. However, you can do some things to avoid complications like blood clots: […] Exercise daily. […] Avoid smoking. […] Avoid high altitude environments. […] Aim to keep your blood pressure at a normal range. […] Maintain a healthy weight.

• #11 Reducing Cardiovascular Risk in Patients With Polycythemia Vera

  https://www.ajmc.com/view/reducing-cardiovascular-risk-in-patients-with-polycythemia-vera

  Similarly, ESC/European Atherosclerosis Society (EAS) recommend treatment of dyslipidemias with a target of 50% reduction low-density lipoprotein cholesterol (LDL-C) levels. However, lifestyle medications should be introduced as the first line of treatment, including diet, weight, and smoking factors. […] Lastly, in the prevention of thrombotic events, recommendations include prior cytoreductive therapy and anticoagulant therapy for individuals with PV and prior thrombotic events. In the case of no prior thrombotic events, treatment recommendations include a hematocrit (Ht) target of less than 45%, acetylsalicylic acid (ASA) of 40-100 mg per day, and cytoreductive therapy for high-risk PV. […] Strict control of CV risk factors, in association with appropriate hematological therapy, may improve outcomes of patients with Ph-MPN [Ph-positive MPN].

• #12 Polycythemia Vera: Barriers to and Strategies for Optimal Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10749566/

  Therefore, it is highly recommended to manage these factors and promote a healthy lifestyle with an adequate diet, reduced smoking and alcohol consumption, and regular exercise. […] Overall, a healthy and varied diet, together with regular exercise, should be encouraged for MPN patients, but, for the large part, these are not implemented in routine care. […] Venesection (VS) remains the cornerstone treatment for PV. […] Thus, beyond the risk stratification, VS is indicated in PV patients with elevated Hct levels (45%). […] In summary, guidelines suggest VS should begin as soon as possible after diagnosis to keep Hct 45%. […] The use of aspirin in PV has historically been debated. […] In the case of intolerance to aspirin, such as mild indigestion, gastric ulcers or bleeding events, among others, clopidogrel (an ADP-receptor antagonist) should be used, although limited data are available about its role in preventing TE in the PV population.

• #13 Polycythemia vera – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/polycythemia-vera/diagnosis-treatment/drc-20355855

  Gentle exercise, such as walking, can improve blood flow. This helps lower the risk of blood clots. […] Using tobacco can narrow your blood vessels. This raises the risk of heart attack or stroke due to blood clots. […] Living at high altitudes, skiing or climbing in mountains all reduce the oxygen levels in your blood. […] To reduce itching, bathe in cool water, use a gentle cleanser and pat your skin dry. […] Poor blood flow increases your risk of injury from hot and cold temperatures. In cold weather, always wear warm clothing. […] Poor blood flow can make it hard for sores to heal. Look at your hands and feet often. Tell your healthcare professional about any sores.

• #14 Living with Polycythemia Vera | Hematology-Oncology Associates of CNY

  https://www.hoacny.com/patient-resources/blood-disorders/what-polycythemia-vera/living-polycythemia-vera

  Polycythemia vera (PV) develops very slowly. It may not cause signs or symptoms for years. If you have PV, the sooner it’s diagnosed, the sooner your doctor can begin treating you. With proper treatment, you can prevent or delay complications. […] Moderate physical activities, such as walking, can safely increase your heart rate and improve blood flow to your body. Improving blood flow lowers your risk of blood clots. Leg and ankle stretching exercises also can help improve your blood flow. […] If you have PV, avoid long-term exposure to extremes in temperature or pressure. […] Follow your treatment plan and take all of your medicines exactly as your doctor prescribes.

• #15 Polycythemia Vera: What’s the Treatment?

  https://www.webmd.com/cancer/polycythemia-vera-treatments

  Polycythemia vera (PV) causes your bone marrow to make too many red blood cells. You need these cells to carry oxygen around your body, but too many of them can make your blood thicken and form clots. Sometimes blood clots lead to a heart attack or stroke. […] Treatments lower the number of red blood cells and prevent blood clots. […] Aspirin thins your blood and prevents clots. […] Daily aspirin use has some risks. It can make bleeding more likely, especially in the stomach and other parts of your digestive system. […] Exercise daily. Staying active will help keep your blood flowing and prevent clots. […] Drink a lot of water. Extra fluids will help prevent your blood from getting too thick.

• #16 Polycythemia Vera: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17742-polycythemia-vera

  Polycythemia vera is a chronic condition with no cure, but medical care can help you manage symptoms and the risk of complications. […] In addition to regular testing and treatment, your healthcare provider will likely recommend general lifestyle changes to help prevent blood clots and other complications. For example: Exercise. Even moderate exercise can help improve sluggish circulation. […] The most significant threat from polycythemia vera isnt from cancer itself, but from the risk of blood clots. If youre living with PV, make sure to see your healthcare provider regularly. And dont neglect taking care of yourself in the little ways healthy lifestyle habits that can help maintain your general cardiovascular health, which might turn out to be just as important as any medical treatment for polycythemia vera.

• #17 Living with Polycythemia Vera | Hematology-Oncology Associates of CNY

  https://www.hoacny.com/patient-resources/blood-disorders/what-polycythemia-vera/living-polycythemia-vera

  Polycythemia vera (PV) develops very slowly. It may not cause signs or symptoms for years. If you have PV, the sooner it’s diagnosed, the sooner your doctor can begin treating you. With proper treatment, you can prevent or delay complications. […] Moderate physical activities, such as walking, can safely increase your heart rate and improve blood flow to your body. Improving blood flow lowers your risk of blood clots. Leg and ankle stretching exercises also can help improve your blood flow. […] If you have PV, avoid long-term exposure to extremes in temperature or pressure. […] Follow your treatment plan and take all of your medicines exactly as your doctor prescribes.

• #18 Polycythemia vera – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/polycythemia-vera/diagnosis-treatment/drc-20355855

  Gentle exercise, such as walking, can improve blood flow. This helps lower the risk of blood clots. […] Using tobacco can narrow your blood vessels. This raises the risk of heart attack or stroke due to blood clots. […] Living at high altitudes, skiing or climbing in mountains all reduce the oxygen levels in your blood. […] To reduce itching, bathe in cool water, use a gentle cleanser and pat your skin dry. […] Poor blood flow increases your risk of injury from hot and cold temperatures. In cold weather, always wear warm clothing. […] Poor blood flow can make it hard for sores to heal. Look at your hands and feet often. Tell your healthcare professional about any sores.

• #19 Polycythemia Vera – What You Need to Know

  https://www.drugs.com/cg/polycythemia-vera.html

  What can I do to prevent blood clots? […] Do not smoke. Nicotine and other chemicals in cigarettes and cigars can increase your risk for blood clots and cause lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products. […] Help keep your blood flowing. Wear support stockings as directed. Support stockings are tight and help push blood up and out of your leg veins. Elevate your feet when you sit. This will help prevent blood from pooling in your leg veins. […] Exercise as directed. Exercise such as walking helps improve blood flow and prevents blood clots. Ask your healthcare provider which exercises are best for you. Stop if you feel any chest pain or shortness of breath. […] Drink liquids as directed. Liquids help keep your blood thin. Your healthcare provider may recommend that you drink at least 3 liters (12 cups) of liquid each day. Ask which liquids are best for you.

• #20 Living with Polycythemia Vera | Hematology-Oncology Associates of CNY

  https://www.hoacny.com/patient-resources/blood-disorders/what-polycythemia-vera/living-polycythemia-vera

  Polycythemia vera (PV) develops very slowly. It may not cause signs or symptoms for years. If you have PV, the sooner it’s diagnosed, the sooner your doctor can begin treating you. With proper treatment, you can prevent or delay complications. […] Moderate physical activities, such as walking, can safely increase your heart rate and improve blood flow to your body. Improving blood flow lowers your risk of blood clots. Leg and ankle stretching exercises also can help improve your blood flow. […] If you have PV, avoid long-term exposure to extremes in temperature or pressure. […] Follow your treatment plan and take all of your medicines exactly as your doctor prescribes.

• #21 Polycythemia Vera

  https://oumedicine.staywellsolutionsonline.com/Library/DiseasesConditions/Adult/Hematology/85,P00107

  Polycythemia vera is a rare, chronic type of blood cancer in which there is an increase in all blood cells, particularly red blood cells. […] Sticking to your treatment plan, exercising, getting enough fluids, and staying away from extreme heat and cold can help prevent or decrease symptoms. […] You should also be physically active to increase your heart rate and improve your blood flow. […] Other ways to improve your blood flow include: […] Staying away from extreme heat and cold. […] Drinking plenty of water. […] Don’t smoke. […] This condition can cause circulation problems. So take care of your hands and feet. Protect them from injuries from cold and heat. For example, always wear shoes, even in your home. Wear warm gloves and socks during cold weather.

• #22 Self-Care for Polycythemia Vera: Exercise, Skin Care, and More

  https://www.healthline.com/health/polycythemia-vera/polycythemia-vera-self-care-from-head-to-toe

  If you have polycythemia vera (PV), its important to keep regular checkups with your doctor, follow your prescribed treatment plan, and adopt these self-care habits to help manage the disease. […] Avoid tobacco to reduce your risk of blood clots. […] Drinking enough water is important to reduce the chance of these complications. […] When living with PV, avoid bathing in hot water, such as in hot tubs or showers. Your doctor is also likely to ask you to avoid or stop smoking. […] When you have PV, staying hydrated is important. It will help you keep good blood flow and circulation, as well as prevent dehydration. […] For this reason, its important to always wear sunscreen and protective clothing and try to stay in the shade during peak daylight hours when outdoors. […] For this reason, its important to dress appropriately in cold weather with items such as gloves, a scarf, and a hat. […] Consider joining a support group for people with this disease. […] Treatment is available, and adjusting some lifestyle habits like staying active, staying hydrated, and taking care of your skin can help you manage your symptoms.

• #23 Self-Care for Polycythemia Vera: Exercise, Skin Care, and More

  https://www.healthline.com/health/polycythemia-vera/polycythemia-vera-self-care-from-head-to-toe

  If you have polycythemia vera (PV), its important to keep regular checkups with your doctor, follow your prescribed treatment plan, and adopt these self-care habits to help manage the disease. […] Avoid tobacco to reduce your risk of blood clots. […] Drinking enough water is important to reduce the chance of these complications. […] When living with PV, avoid bathing in hot water, such as in hot tubs or showers. Your doctor is also likely to ask you to avoid or stop smoking. […] When you have PV, staying hydrated is important. It will help you keep good blood flow and circulation, as well as prevent dehydration. […] For this reason, its important to always wear sunscreen and protective clothing and try to stay in the shade during peak daylight hours when outdoors. […] For this reason, its important to dress appropriately in cold weather with items such as gloves, a scarf, and a hat. […] Consider joining a support group for people with this disease. […] Treatment is available, and adjusting some lifestyle habits like staying active, staying hydrated, and taking care of your skin can help you manage your symptoms.

• #24 Polycythemia vera treatment algorithm 2018 | Blood Cancer Journal

  https://www.nature.com/articles/s41408-017-0042-7

  Currently available drugs for PV have not been shown to prolong survival or alter the natural history of the disease and are instead indicated primarily for prevention of thrombosis. […] Keeping these issues in mind, at present, we continue to advocate conservative management in low-risk PV (phlebotomy combined with once- or twice-daily aspirin therapy) and include cytoreductive therapy in high-risk patients; […] Accordingly, we recommend aspirin therapy (81-100mg once-daily) + phlebotomy with a target hematocrit of 45%, in all male and female patients with PV, regardless of risk status. […] Finally, there is evidence from observational studies that the use of oral anticoagulants, as well as that of aspirin therapy, prevents recurrent venous thrombosis in PV. […] These observations were taken into consideration in formulating our treatment recommendations for high-risk disease.

• #25 Polycythemia Vera Treatment & Management: Approach Considerations, Medical Care, Phlebotomy

  https://emedicine.medscape.com/article/205114-treatment

  The goals of treatment of polycythemia vera (PV) are as follows: […] All patients with PV should undergo phlebotomy to keep their hematocrit below 45%. […] All patients with PV should take aspirin, 81 mg daily, unless contraindicated by major bleeding or gastric intolerance. […] If a patient is at high risk for thrombosis, cytoreductive therapy is added to the management plan. […] The Polycythemia Vera Study Group (PVSG) demonstrated a decreased survival rate and increased mortality rate from acute leukemia in the first 5 years, and a total of 17% of patients had leukemia after 15 years with chlorambucil and with phosphorus-32. […] An increased incidence of thrombotic complications occurred in the phlebotomy arm. […] Low-dose aspirin suppresses thromboxane biosynthesis by platelets, which is increased in PV and essential thrombocythemia.

• #26 Polycythemia vera treatment algorithm 2018 | Blood Cancer Journal

  https://www.nature.com/articles/s41408-017-0042-7

  Currently available drugs for PV have not been shown to prolong survival or alter the natural history of the disease and are instead indicated primarily for prevention of thrombosis. […] Keeping these issues in mind, at present, we continue to advocate conservative management in low-risk PV (phlebotomy combined with once- or twice-daily aspirin therapy) and include cytoreductive therapy in high-risk patients; […] Accordingly, we recommend aspirin therapy (81-100mg once-daily) + phlebotomy with a target hematocrit of 45%, in all male and female patients with PV, regardless of risk status. […] Finally, there is evidence from observational studies that the use of oral anticoagulants, as well as that of aspirin therapy, prevents recurrent venous thrombosis in PV. […] These observations were taken into consideration in formulating our treatment recommendations for high-risk disease.

• #27 Polycythemia Vera Treatment & Management: Approach Considerations, Medical Care, Phlebotomy

  https://emedicine.medscape.com/article/205114-treatment

  The goals of treatment of polycythemia vera (PV) are as follows: […] All patients with PV should undergo phlebotomy to keep their hematocrit below 45%. […] All patients with PV should take aspirin, 81 mg daily, unless contraindicated by major bleeding or gastric intolerance. […] If a patient is at high risk for thrombosis, cytoreductive therapy is added to the management plan. […] The Polycythemia Vera Study Group (PVSG) demonstrated a decreased survival rate and increased mortality rate from acute leukemia in the first 5 years, and a total of 17% of patients had leukemia after 15 years with chlorambucil and with phosphorus-32. […] An increased incidence of thrombotic complications occurred in the phlebotomy arm. […] Low-dose aspirin suppresses thromboxane biosynthesis by platelets, which is increased in PV and essential thrombocythemia.

• #28 Polycythemia vera | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/leukemia/what-is-leukemia/myeloproliferative-neoplasms/polycythemia-vera

  The goal of treatments for PV is to control symptoms and lower the risk of complications. Treatments can be done to: […] prevent bleeding […] stop blood clots. […] Low dose acetylsalicylic acid (ASA, or Aspirin) is given to lower the risk of a blood clot. ASA makes platelets less likely to stick to the wall of an artery and build up to form a clot. This helps reduce the risk of a stroke or heart attack. Your healthcare team may suggest other ways you can reduce this risk, including quitting smoking. […] Talk to your doctor about clinical trials open to people with MPNs in Canada. Clinical trials look at new ways to prevent, find and treat diseases.

• #29 Polycythemia Vera: Barriers to and Strategies for Optimal Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10749566/

  Therefore, it is highly recommended to manage these factors and promote a healthy lifestyle with an adequate diet, reduced smoking and alcohol consumption, and regular exercise. […] Overall, a healthy and varied diet, together with regular exercise, should be encouraged for MPN patients, but, for the large part, these are not implemented in routine care. […] Venesection (VS) remains the cornerstone treatment for PV. […] Thus, beyond the risk stratification, VS is indicated in PV patients with elevated Hct levels (45%). […] In summary, guidelines suggest VS should begin as soon as possible after diagnosis to keep Hct 45%. […] The use of aspirin in PV has historically been debated. […] In the case of intolerance to aspirin, such as mild indigestion, gastric ulcers or bleeding events, among others, clopidogrel (an ADP-receptor antagonist) should be used, although limited data are available about its role in preventing TE in the PV population.

• #30 Polycythemia Vera Treatment & Management: Approach Considerations, Medical Care, Phlebotomy

  https://emedicine.medscape.com/article/205114-treatment

  The goals of treatment of polycythemia vera (PV) are as follows: […] All patients with PV should undergo phlebotomy to keep their hematocrit below 45%. […] All patients with PV should take aspirin, 81 mg daily, unless contraindicated by major bleeding or gastric intolerance. […] If a patient is at high risk for thrombosis, cytoreductive therapy is added to the management plan. […] The Polycythemia Vera Study Group (PVSG) demonstrated a decreased survival rate and increased mortality rate from acute leukemia in the first 5 years, and a total of 17% of patients had leukemia after 15 years with chlorambucil and with phosphorus-32. […] An increased incidence of thrombotic complications occurred in the phlebotomy arm. […] Low-dose aspirin suppresses thromboxane biosynthesis by platelets, which is increased in PV and essential thrombocythemia.

• #31 Different effect of hydroxyurea and phlebotomy on prevention of arterial and venous thrombosis in Polycythemia Vera | Blood Cancer Journal

  https://www.nature.com/articles/s41408-018-0161-9

  Clonal proliferation of hematopoietic precursors leading to progressive expansion of myeloid cells with a predominant increase of red cells characterizes the hematological phenotype of Polycythemia Vera (PV). The resulting blood hyperviscosity is a major determinant of vascular complications which severely impact on morbidity and mortality of these patients. Aggressive maintenance of a target hematocrit level lower than 45% with phlebotomy (PHL), either alone or associated with cytoreductive drugs, and low-dose aspirin have been shown to reduce the thrombosis rate in the randomized controlled CYTO-PV and European Collaborative Low-dose Aspirin Polycythemia Vera (ECLAP) clinical trials, respectively, and are recommended therapies in the clinical practice. […] In patients at high-risk because of age and/or history of thrombosis, hydroxyurea (HU) is the recommended front-line cytoreductive drug based on a small observational study (PVSG protocol 08), in which 51 HU-treated patients experienced a lower incidence of thrombosis compared with historical controls managed with PHL.

• #32 Preventing Thrombosis in Patients with Polycythemia Vera

  https://www.targetedonc.com/view/preventing-thrombosis-in-patients-with-polycythemia-vera

  You want to, in either case, minimize the time the patients spend at about 45% hematocrit, because that increases the risk of blood clotting and the risk of dying. In the low-risk patients this is done by frequent phlebotomist, which means bloodletting. […] In the high-risk group, we give patients, on top of phlebotomy, medications to eliminate the need for phlebotomy, because they’re at higher risk for blood clotting. […] The goal here is to smooth that hematocrit percent below 45% all the time and eliminate a need for phlebotomy. […] And this is critical to maintain the patients below 45% all the time, particularly in the high-risk group. […] With the inability to control it we need new agents that would help maintain the hematocrit below 45% in high-risk group all the time. So, the need is there, either in the low risk group or in the high risk group to help achieve the goal of the therapy.

• #33 Different effect of hydroxyurea and phlebotomy on prevention of arterial and venous thrombosis in Polycythemia Vera | Blood Cancer Journal

  https://www.nature.com/articles/s41408-018-0161-9

  The recommendation that HU should be a first line therapy has been criticized since no solid demonstration of its efficacy to prevent thrombosis or prolong survival has been produced so far. […] Recently, we documented an advantage of HU over PHL in a cohort of 1042 patients with PV included in the ECLAP trial consistently significant with respect to the proportion of fatal/non-fatal CV events (13.2% vs. 7.9% in PHL vs. HU groups, respectively, p=0.006) and myelofibrosis transformation, that was more frequent in patients treated with PHL only. […] To our knowledge, this is the first study documenting the greater antithrombotic protection of HU over PHL against arterial thrombosis while the two treatments produce similar results in the protection from venous thrombosis. […] Moreover, the antithrombotic effect of this drug may recognize additional mechanisms of action besides pan-myelosuppression, including qualitative changes in leukocytes, decreased expression of endothelial adhesion molecules, and enhanced nitric oxide (NO) generation.

• #34 Diagnosis and Treatment Options for Polycythemia Vera | MDedge

  https://medauth2.mdedge.com/content/diagnosis-and-treatment-options-polycythemia-vera-0

  The first thing we as physicians are worried about is patients with PV developing thrombosis. We start prophylaxis with aspirin, as aspirin remains the best treatment for reducing this risk. It is essential to make sure patients with PV understand the importance of taking an aspirin, even at a low dosage. […] Phlebotomy should be part of the treatment options for patients with PV, especially patients in the high-risk range who have high hemoglobin and hematocrit values. […] Hydroxyurea is our standard of care with strong beneficial data for this purpose. […] These 3 strategies can improve a patient’s life and reduce their risk for thrombosis.

• #35 Polycythemia Vera: Barriers to and Strategies for Optimal Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10749566/

  Direct oral anticoagulation (DOAC) therapy usage has been raised in the last year to prevent and treat TE in cardiovascular diseases. […] Despite the current limited knowledge, overall, the use of DOAC has been extended and appears safe and efficacious for preventing and treating TE in PV. […] Hydroxycarbamide (HC) has been the gold standard treatment in PV patients for years. […] The central challenge in managing PV patients with HC is the development of intolerance and resistance to the medication, which could lead to the interruption of therapy. […] In younger patients, in whom HC use could lead to critical long-term toxicities, or in those refractories to previous therapy, interferon- (IFN) represents the treatment of choice and, more recently, is considered perhaps the optimum treatment.

• #36 Getting Closer to Disease Modification in Polycythemia Vera – Conquer: the journey informed

  https://conquer-magazine.com/issues/2025/vol-11-no-1-february-2025/getting-closer-to-disease-modification-in-polycythemia-vera

  Polycythemia vera is a chronic, incurable disease of the hematopoietic stem cells, the primary cells that can develop into different types of blood cells and are responsible for the production of blood cells during a humans entire life. […] The invention of JAK inhibitors and the approval of ruxolitinib in 2014 as the only JAK inhibitor for refractory patients with polycythemia vera allowed excellent control of the inflammation, symptoms, and overall outcome of the disease; however, it fell short of altering the long-term behavior of the disease. […] Although such evidence was gradually emerging from the study of interferons (injectable drugs used off-label in this indication since the early 1990s), it wasn’t until November 2021 that the first interferon approved specifically for MPNs, known as ropeginterferon alfa-2b, gained official approval as a promising agent to possibly alter the disease course through disease modification or prevention of the progression to myelofibrosis. […] Normalization of blood counts, alleviation of symptoms, and prevention of disease-related complications should remain the cornerstones of polycythemia vera treatment, along with an individualized approach that will offer the best possible disease control for everyone.

• #37 Polycythemia Vera: Barriers to and Strategies for Optimal Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10749566/

  The Janus kinase inhibitors (JAKi) widely impacted the treatment of MF, above all in the patients with worse prognosis according to the standard prognostic models, where over the years, several JAKi were tested and are currently used with significant results in terms of symptoms control, improvement in quality of life, and aiming to modify the disease outcome, alone or combined to other molecules with a different mechanism of action. […] A brief explanation of the available strategies to control PV clinical manifestations and reduce thrombotic risk, with their common side effects, is reported in Table 2.

• #38 Diagnosis and Treatment Options for Polycythemia Vera | AVAHO

  https://www.mdedge9-ma1.mdedge.com/fedprac/avaho/article/267715/diagnosis-and-treatment-options-polycythemia-vera

  The first thing we as physicians are worried about is patients with PV developing thrombosis. We start prophylaxis with aspirin, as aspirin remains the best treatment for reducing this risk. It is essential to make sure patients with PV understand the importance of taking an aspirin, even at a low dosage. […] Phlebotomy should be part of the treatment options for patients with PV, especially patients in the high-risk range who have high hemoglobin and hematocrit values. […] These 3 strategies can improve a patient’s life and reduce their risk for thrombosis. […] Hydroxyurea is our standard of care with strong beneficial data for this purpose. […] I never skip aspirin since it is such an important part of treatment for patients with PV. […] Now that we have JAK2 inhibitors, ruxolitinib is generally my choice for patients who cannot tolerate hydroxyurea, which is more common than maybe we would like. […] We now have options for controlling the disease and its complications, but the hardest thing is to tell patients that none of these treatments are going to cure them or reverse the overproduction of red blood cells in their bone marrow.

• #39 A guideline for the management of specific situations in polycythaemia vera and secondary erythrocytosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6519221/

  Thrombotic events are the major cause of morbidity and mortality in PV, and their prevention is the main objective of treatment. […] Both primary and secondary prevention should include control of cardiovascular risk factors in accordance with current recommendations (NICE, 2014). […] In accordance with evidence for the management of PV, low-dose aspirin should be offered to all patients (Landolfi et al, 2004). […] Indefinite anticoagulation for VTE is recommended because of the presence of continuing risk (NICE 2012; Watson et al, 2015; Kearon et al, 2016). […] For unprovoked VTE, where there is no physical precipitating factor, we therefore recommend indefinite anticoagulation to reduce the incidence of recurrence. […] Patients should be screened for hypertension, hyperlipidaemia, diabetes mellitus and a smoking history. (GRADE 1B)

• #40 Polycythemia Vera: Barriers to and Strategies for Optimal Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10749566/

  Direct oral anticoagulation (DOAC) therapy usage has been raised in the last year to prevent and treat TE in cardiovascular diseases. […] Despite the current limited knowledge, overall, the use of DOAC has been extended and appears safe and efficacious for preventing and treating TE in PV. […] Hydroxycarbamide (HC) has been the gold standard treatment in PV patients for years. […] The central challenge in managing PV patients with HC is the development of intolerance and resistance to the medication, which could lead to the interruption of therapy. […] In younger patients, in whom HC use could lead to critical long-term toxicities, or in those refractories to previous therapy, interferon- (IFN) represents the treatment of choice and, more recently, is considered perhaps the optimum treatment.

• #41 A guideline for the management of specific situations in polycythaemia vera and secondary erythrocytosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6519221/

  Cardiovascular risk should be assessed at baseline and annually using a validated score such as QRISK score. (GRADE 2C) […] Indefinite anticoagulation should be initiated for unprovoked venous thromboembolism dependent on bleeding risk. (GRADE 2C) […] Cytoreduction and venesection to keep haematocrit (Hct) 045. (GRADE 1A) […] Preoperative planning should involve a haematologist to optimise count control and individualise perioperative plan. (GRADE 1B) […] There should be close collaborative management between obstetrician and haematologist to formulate an individualised plan for the pregnancy, delivery and postpartum period based on the previous history of thrombosis, haemorrhage and previous pregnancies. (GRADE 1C) […] Avoid cytoreductive therapy (such as hydroxycarbamide and anagrelide) for a minimum of 3 months in male and female patients prior to planned conception and in the first trimester. Commence interferon if cytoreduction is required. (GRADE 1C)

• #42 A Case of Polycythemia Vera with Massive Bleeding After Surgery

  https://www.jstage.jst.go.jp/article/ijswc/3/4/3_132/_article/-char/en

  Polycythemia vera is a myeloproliferative neoplasm that can cause opposite complications: thrombosis and bleeding. Since arterial or venous thrombosis is often fatal, prevention of thrombogenesis is the main treatment measure for polycythemia vera, both in daily life and perioperatively. […] Regarding the perioperative complications of polycythemia vera, not only thrombosis, but also bleeding should be considered. Strict control of patients’ hematocrit and platelet count with phlebotomy and/or hydroxyurea as cytoreduction therapy is essential.

• #43 A guideline for the management of specific situations in polycythaemia vera and secondary erythrocytosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6519221/

  Cardiovascular risk should be assessed at baseline and annually using a validated score such as QRISK score. (GRADE 2C) […] Indefinite anticoagulation should be initiated for unprovoked venous thromboembolism dependent on bleeding risk. (GRADE 2C) […] Cytoreduction and venesection to keep haematocrit (Hct) 045. (GRADE 1A) […] Preoperative planning should involve a haematologist to optimise count control and individualise perioperative plan. (GRADE 1B) […] There should be close collaborative management between obstetrician and haematologist to formulate an individualised plan for the pregnancy, delivery and postpartum period based on the previous history of thrombosis, haemorrhage and previous pregnancies. (GRADE 1C) […] Avoid cytoreductive therapy (such as hydroxycarbamide and anagrelide) for a minimum of 3 months in male and female patients prior to planned conception and in the first trimester. Commence interferon if cytoreduction is required. (GRADE 1C)

• #44 A guideline for the management of specific situations in polycythaemia vera and secondary erythrocytosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6519221/

  Cardiovascular risk should be assessed at baseline and annually using a validated score such as QRISK score. (GRADE 2C) […] Indefinite anticoagulation should be initiated for unprovoked venous thromboembolism dependent on bleeding risk. (GRADE 2C) […] Cytoreduction and venesection to keep haematocrit (Hct) 045. (GRADE 1A) […] Preoperative planning should involve a haematologist to optimise count control and individualise perioperative plan. (GRADE 1B) […] There should be close collaborative management between obstetrician and haematologist to formulate an individualised plan for the pregnancy, delivery and postpartum period based on the previous history of thrombosis, haemorrhage and previous pregnancies. (GRADE 1C) […] Avoid cytoreductive therapy (such as hydroxycarbamide and anagrelide) for a minimum of 3 months in male and female patients prior to planned conception and in the first trimester. Commence interferon if cytoreduction is required. (GRADE 1C)

• #45 Polycythemia Vera in Pregnancy: A Descriptive Review of the Literature

  https://www.imrpress.com/journal/CEOG/50/4/10.31083/j.ceog5004077/htm

  In pregnancies determined to be at higher risk for thrombosis, the recommendation is to initiate more intensive therapy by adding a prophylactic dose of low molecular weight heparin (LMWH). […] A meta-analysis on the number of live births and maternal complications in pregnant patients with PV found that evidence of the benefit from aspirin or interferon treatment was of moderate quality. […] They concluded that aggressive intervention with tight hematocrit control, aspirin, and LMWH is associated with significantly better outcomes for mother and infant. […] It is therefore recommended to stop hydroxyurea at least 3 months before becoming pregnant. IFN-α is the treatment of choice in younger patients and pregnant patients due to its assumed safety in pregnancy and potential to achieve cytogenetic remission. […] NCCN guidelines state that interferon alfa-2b, peginterferon alfa-2a, or peginterferon alfa-2b can be considered for higher risk pregnant patients requiring cytoreductive therapy.

• #46 Polycythemia Vera in Pregnancy: A Descriptive Review of the Literature

  https://www.imrpress.com/journal/CEOG/50/4/10.31083/j.ceog5004077/htm

  Polycythemia vera (PV) is a rare myeloproliferative neoplasm that is associated with a high risk of thrombosis due to an increase in red blood cell mass and hyperviscosity. […] In pregnancy, the mainstay interventions are serial phlebotomies to maintain the hematocrit in an appropriate range and daily low dose aspirin therapy. Low molecular weight heparin is added for pregnant patients thought to be at additional risk for thrombosis. […] Based on very limited data, these interventions have been reported to improve pregnancy outcomes. […] The main interventional strategies focus on prevention of thrombotic complications. Their guidelines direct that in otherwise low-risk pregnancies, it is recommended to keep the hematocrit within a gestational-appropriate range via serial phlebotomies, and to use low-dose aspirin throughout pregnancy and the postpartum period.

• #47 Polycythemia Vera in Pregnancy: A Descriptive Review of the Literature

  https://www.imrpress.com/journal/CEOG/50/4/10.31083/j.ceog5004077/htm

  In pregnancies determined to be at higher risk for thrombosis, the recommendation is to initiate more intensive therapy by adding a prophylactic dose of low molecular weight heparin (LMWH). […] A meta-analysis on the number of live births and maternal complications in pregnant patients with PV found that evidence of the benefit from aspirin or interferon treatment was of moderate quality. […] They concluded that aggressive intervention with tight hematocrit control, aspirin, and LMWH is associated with significantly better outcomes for mother and infant. […] It is therefore recommended to stop hydroxyurea at least 3 months before becoming pregnant. IFN-α is the treatment of choice in younger patients and pregnant patients due to its assumed safety in pregnancy and potential to achieve cytogenetic remission. […] NCCN guidelines state that interferon alfa-2b, peginterferon alfa-2a, or peginterferon alfa-2b can be considered for higher risk pregnant patients requiring cytoreductive therapy.

• #48

  https://haematologica.org/article/view/4771

  The search for new strategies for high risk polycythemia vera and essential thrombocythemia subjects has undoubtedly become a priority for future research. Early recognition of the myeloproliferative disorder and wider use of aspirin and cytoreduction have likely contributed to lowering the incidence of thrombotic events. […] In addition, in very high risk patients, the association of hydroxyurea and aspirin, which is currently viewed as an aggressive treatment, does not seem well suited to the patients risk level, which calls for the adoption of more aggressive antithrombotic or cytoreductive strategies or for the search for novel treatment approaches.

• #49 Rusfertide Cuts Number of Needed Blood Draws to Treat PCV – NCI

  https://www.cancer.gov/news-events/cancer-currents-blog/2024/rusfertide-polycythemia-vera-fewer-phlebotomies

  For people with polycythemia vera, treatment with the drug rusfertide appears to substantially reduce their reliance on blood draws to avoid serious health problems. […] The need to make regular trips to a doctors office for the procedure is also time consuming and affects peoples quality of life. […] So Dr. Kremyanskaya began studying treatments that specifically suppress red blood cell formationcalling it a chemical phlebotomy. […] Adding rusfertide to their ongoing treatment of phlebotomy had a major impact, Dr. Kremyanskaya said. […] For most participants who received rusfertide, [their] need for phlebotomy was significantly reduced or eliminated, she said, dropping from an average of nine phlebotomies per year before the trial to less than one phlebotomy per year after starting rusfertide.

• #50 Rusfertide Cuts Number of Needed Blood Draws to Treat PCV – NCI

  https://www.cancer.gov/news-events/cancer-currents-blog/2024/rusfertide-polycythemia-vera-fewer-phlebotomies

  The bottom line, Dr. Kremyanskaya said, is that, beyond phlebotomy, there are actually very few treatment options. […] Rusfertide appears to help people with polycythemia vera maintain healthy hematocrit levels without the need for phlebotomy for more than 2 years, according to findings from the third and final part of the REVIVE trial, presented at the American Society of Hematology Annual Meeting in December 2023. […] More definitive findings will come from a larger phase 3 trial, called VERIFY, that is now underway. […] One important question to answer is if rusfertide reduces the risk of heart attack and stroke in people with polycythemia vera, Dr. Amanam noted. […] Whether or not rusfertide increases the risk of skin cancer is unknown, but we need to be vigilant about monitoring, Dr. Kremyanskaya emphasized. […] But hes hopeful that rusfertide may eventually offer a new option for people with polycythemia vera to recapture part of their lives.

• #51 Selected ASH Abstracts on Novel Treatments of Polycythemia Vera – The ASCO Post

  https://ascopost.com/issues/december-25-2020/selected-ash-abstracts-on-novel-treatments-of-polycythemia-vera/

  PTG-300 looks promising in eliminating therapeutic phlebotomies in both low- and high-risk patients with polycythemia vera. […] The current results indicate that PTG-300 is an effective agent for the treatment of polycythemia vera, eliminating the need for therapeutic phlebotomy in patients by mimicking hepcidin and hence limiting the use of iron in erythropoiesis (and thus substitutes for phlebotomy). Elimination of therapeutic phlebotomy requirements for 7 months in therapeutic phlebotomy-dependent patients with polycythemia vera is significant and allows iron deficiency to slowly resolve. […] Considering the high and durable hematologic and molecular responses and its tolerability, ropeginterferon -2b offers a valuable and safe long-term treatment option, with features distinctly improved from hydroxyurea.

• #52 Link Between Elevated WBC and Thrombotic Events in Polycythemia Vera Highlights Potential Prevention Strategy

  https://www.onclive.com/view/link-between-elevated-wbc-and-thrombotic-events-in-polycythemia-vera-highlights-potential-prevention-strategy

  Patients with polycythemia vera who have controlled hematocrit levels, but elevated white blood counts are at an increased risk of thrombotic events, according to a presentation of the REVEAL study. […] The findings suggest that by controlling WBC in patients with PV, the risk of TEs may also be controlled. […] This analysis of the REVEAL study, which is the largest real-world cohort of patients with PV prospectively studied, demonstrated that there was an association between elevated blood counts and thrombotic events, particularly a white blood cell count over 11 in all patients, Gerds concluded. […] He added that We should be moving beyond the conventional risk models, and start to include additional factorswhether we’re talking about blood counts, allele burdens, even lymphocyte counts, perhapsto make better models to predict thrombosis. Because thrombosis is associated with inferior outcomes overall in these populations, if we can make better models, we can intervene in higher-risk populations to improve their overall outcomes.

• #53

  https://haematologica.org/article/view/4771

  Identifying the most safe and effective strategy for reducing the vascular risk of subjects with polycythemia vera and essential thrombocythemia has always been challenging. […] The presence of a myeloproliferative disorder should, however, increase efforts to identify and treat any additional risk factors and encourage the patient to adopt a healthy life-style. Particular attention should be given to smoking, which has an important effect on vascular risk and was found to be surprisingly common among polycythemia vera patients recruited in the ECLAP observational study. […] Successful changes in modifiable risk factors require full co-operation from the patient and this underlines the importance of sharing treatment decisions and goals with the patient. […] These recommendations do not include interventions on life style and all modifiable factors because these apply uniformly to all patients.

• #54 Getting Closer to Disease Modification in Polycythemia Vera – Conquer: the journey informed

  https://conquer-magazine.com/issues/2025/vol-11-no-1-february-2025/getting-closer-to-disease-modification-in-polycythemia-vera

  Polycythemia vera is a chronic, incurable disease of the hematopoietic stem cells, the primary cells that can develop into different types of blood cells and are responsible for the production of blood cells during a humans entire life. […] The invention of JAK inhibitors and the approval of ruxolitinib in 2014 as the only JAK inhibitor for refractory patients with polycythemia vera allowed excellent control of the inflammation, symptoms, and overall outcome of the disease; however, it fell short of altering the long-term behavior of the disease. […] Although such evidence was gradually emerging from the study of interferons (injectable drugs used off-label in this indication since the early 1990s), it wasn’t until November 2021 that the first interferon approved specifically for MPNs, known as ropeginterferon alfa-2b, gained official approval as a promising agent to possibly alter the disease course through disease modification or prevention of the progression to myelofibrosis. […] Normalization of blood counts, alleviation of symptoms, and prevention of disease-related complications should remain the cornerstones of polycythemia vera treatment, along with an individualized approach that will offer the best possible disease control for everyone.

• #55

  https://haematologica.org/article/view/4771

  Identifying the most safe and effective strategy for reducing the vascular risk of subjects with polycythemia vera and essential thrombocythemia has always been challenging. […] The presence of a myeloproliferative disorder should, however, increase efforts to identify and treat any additional risk factors and encourage the patient to adopt a healthy life-style. Particular attention should be given to smoking, which has an important effect on vascular risk and was found to be surprisingly common among polycythemia vera patients recruited in the ECLAP observational study. […] Successful changes in modifiable risk factors require full co-operation from the patient and this underlines the importance of sharing treatment decisions and goals with the patient. […] These recommendations do not include interventions on life style and all modifiable factors because these apply uniformly to all patients.

• #56 Supplements for Polycythemia Vera: 5 To Take and 3 To Avoid | myMPNteam

  https://www.mympnteam.com/resources/supplements-for-polycythemia-vera-to-take-and-to-avoid

  Many dietary supplements containing vitamins, minerals, and herbs are available without a prescription. Some may be marketed as having benefits to prevent or treat cancer or reduce cancer treatment side effects. Its very important to follow your doctors advice about which supplements to take and avoid your doctor understands the details of your health condition best. […] Although some supplements may be helpful, you shouldnt use them as a replacement for your usual PV treatment. Before you start taking any supplements, check with your doctor to make sure its safe for you. […] If you have PV, your doctor may ask you to avoid some common vitamins and minerals because they can encourage the production of RBCs. Before you take any supplement, check with your doctor to make sure it doesnt contain an ingredient you should avoid.

• #57 Polycythemia Vera Diet: What to Eat for Better Health

  https://www.verywellhealth.com/polycythemia-vera-diet-5204993

  It is important to limit high-fat foods because they can increase your risk of blood clots and inflammation. […] It is important to eat fresh foods and minimize your intake of highly processed foods and foods that contain preservatives or excessive sugar, which can increase the risk of inflammation and cancer. […] It may help to avoid alcohol, caffeinated beverages, fatty foods, chocolate, and spicy foods while healing. […] When you reduce your intake of certain foods like beans and meat, it’s important that you maintain a varied diet that includes an ample supply of the nutrients in those foods. […] Smoking is not a dietary factor, but this habit can have a detrimental effect on polycythemia vera. If you smoke, it is highly recommended that you quit. […] Avoiding foods and supplements containing iron has been proposed for managing polycythemia vera. […] Healthy eating habits, along with medical treatment, can help you achieve the best quality of life with polycythemia vera.

• #58 Supplements for Polycythemia Vera: 5 To Take and 3 To Avoid | myMPNteam

  https://www.mympnteam.com/resources/supplements-for-polycythemia-vera-to-take-and-to-avoid

  You should never use supplements to replace your doctor-recommended PV treatment. Only FDA-approved medications and treatments for PV are evaluated for safety and effectiveness. Dietary supplements dont have the same strict requirements as approved treatments. Additionally, there arent any clinical trials that show any supplement is safe or effective for PV. […] Before you start taking any new supplement, you should talk to your doctor about the possible benefits, side effects, and drug interactions with your current treatment. Make sure your doctor has an up-to-date list of everything you take, both OTC and prescription, on file.

• #59 Supplements for Polycythemia Vera: 5 To Take and 3 To Avoid | myMPNteam

  https://www.mympnteam.com/resources/supplements-for-polycythemia-vera-to-take-and-to-avoid

  You should never use supplements to replace your doctor-recommended PV treatment. Only FDA-approved medications and treatments for PV are evaluated for safety and effectiveness. Dietary supplements dont have the same strict requirements as approved treatments. Additionally, there arent any clinical trials that show any supplement is safe or effective for PV. […] Before you start taking any new supplement, you should talk to your doctor about the possible benefits, side effects, and drug interactions with your current treatment. Make sure your doctor has an up-to-date list of everything you take, both OTC and prescription, on file.

• #60 Polycythemia Vera: Symptoms, Causes, and Diagnosis

  https://www.healthline.com/health/polycythemia-vera

  Theres no cure for PV, but you can manage the condition with treatment. Your doctor will likely do routine blood draws and prescribe medication to help prevent serious blood clots. […] Recognizing the symptoms early can help you get treatment started and hopefully prevent blood clots and their complications. […] If your doctor tells you that you have PV, keep in mind that the sooner you know, the sooner you can start treatment. And treatment reduces your risk of complications from PV. […] Typical treatment for those at low risk of blood clots includes two things: Aspirin and a procedure called phlebotomy. […] Aspirin affects the platelets in your blood, decreasing your risk of forming blood clots. […] Your doctor may also prescribe other treatments for you. Some of these may help relieve itching, which can be a persistent and bothersome problem for many people with PV.

• #61 Polycythemia Vera: Symptoms, Causes, and Diagnosis

  https://www.healthline.com/health/polycythemia-vera

  Making a few changes to your lifestyle might help you cope with symptoms and reduce your chance of complications. […] That said, its important to speak with your doctor first to make sure these changes are right for you, as every persons needs are different. […] Treating PV helps reduce your risk of life-threatening complications. […] Getting the care you need as soon as possible can help prevent blood clots, decrease complications, and improve the quality and length of your life.

• #62 Polycythemia vera treatment algorithm 2018 | Blood Cancer Journal

  https://www.nature.com/articles/s41408-017-0042-7

  Currently available drugs for PV have not been shown to prolong survival or alter the natural history of the disease and are instead indicated primarily for prevention of thrombosis. […] Keeping these issues in mind, at present, we continue to advocate conservative management in low-risk PV (phlebotomy combined with once- or twice-daily aspirin therapy) and include cytoreductive therapy in high-risk patients; […] Accordingly, we recommend aspirin therapy (81-100mg once-daily) + phlebotomy with a target hematocrit of 45%, in all male and female patients with PV, regardless of risk status. […] Finally, there is evidence from observational studies that the use of oral anticoagulants, as well as that of aspirin therapy, prevents recurrent venous thrombosis in PV. […] These observations were taken into consideration in formulating our treatment recommendations for high-risk disease.

• #63 Polycythemia vera | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/leukemia/what-is-leukemia/myeloproliferative-neoplasms/polycythemia-vera

  The goal of treatments for PV is to control symptoms and lower the risk of complications. Treatments can be done to: […] prevent bleeding […] stop blood clots. […] Low dose acetylsalicylic acid (ASA, or Aspirin) is given to lower the risk of a blood clot. ASA makes platelets less likely to stick to the wall of an artery and build up to form a clot. This helps reduce the risk of a stroke or heart attack. Your healthcare team may suggest other ways you can reduce this risk, including quitting smoking. […] Talk to your doctor about clinical trials open to people with MPNs in Canada. Clinical trials look at new ways to prevent, find and treat diseases.

• #64 Yale Cancer Center investigators show recommended, but underused treatment for rare blood cancer saves lives < Yale School of Medicine

  https://medicine.yale.edu/news-article/yale-cancer-center-investigators-show-recommended-but-underused-treatment-for-rare-blood-cancer-saves-lives/

  U.S. and European guidelines on treating Polycythemia Vera (PV), a potentially deadly blood cancer, call for two treatments for patients with high-risk disease: therapeutic phlebotomy and cytoreductive therapy with a drug called hydroxyurea (HU). […] Use of the two recommended treatments saves lives. […] All of the patients we studied were high-risk for clot development, and we now know from our findings that guideline-recommended treatments reduce the risk of both thrombosis and death, Podoltsev said. We hope that our research will raise clinicians awareness of and adherence to the guidelines and improve the outcomes of PV patients in the future.

• #65 A guideline for the management of specific situations in polycythaemia vera and secondary erythrocytosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6519221/

  Thrombotic events are the major cause of morbidity and mortality in PV, and their prevention is the main objective of treatment. […] Both primary and secondary prevention should include control of cardiovascular risk factors in accordance with current recommendations (NICE, 2014). […] In accordance with evidence for the management of PV, low-dose aspirin should be offered to all patients (Landolfi et al, 2004). […] Indefinite anticoagulation for VTE is recommended because of the presence of continuing risk (NICE 2012; Watson et al, 2015; Kearon et al, 2016). […] For unprovoked VTE, where there is no physical precipitating factor, we therefore recommend indefinite anticoagulation to reduce the incidence of recurrence. […] Patients should be screened for hypertension, hyperlipidaemia, diabetes mellitus and a smoking history. (GRADE 1B)

• #66 Polycythemia Vera

  https://healthlibrary.overlakehospital.org/MentalHealth/85,P00107

  There is no cure for polycythemia vera. But correct treatment can help to reduce or delay any problems. Work with your provider to create a treatment plan that fits your needs. You should also be physically active to increase your heart rate and improve your blood flow. […] Sticking to your treatment plan, exercising, getting enough fluids, and staying away from extreme heat and cold can help prevent or decrease symptoms.

• #67 Screening and Prevention of Polycythemia Vera | Hematology-Oncology Associates of CNY

  https://www.hoacny.com/patient-resources/blood-disorders/what-polycythemia-vera/screening-and-prevention-polycythemia-vera

  Primary polycythemia (polycythemia vera) can’t be prevented. However, with proper treatment, you can prevent or delay symptoms and complications. […] Sometimes you can prevent secondary polycythemia by avoiding things that deprive your body of oxygen for long periods. For example, you can avoid mountain climbing, living at a high altitude, or smoking. […] Following a healthy lifestyle to lower your risk of heart and lung diseases also will help you prevent secondary polycythemia.

• #68 Polycythemia Vera

  https://healthlibrary.olmmed.org/Library/DiseasesConditions/Pediatric/Cardiology/85,P00107

  Sticking to your treatment plan, exercising, getting enough fluids, and staying away from extreme heat and cold can help prevent or decrease symptoms. […] You should also be physically active to increase your heart rate and improve your blood flow. […] Other ways to improve your blood flow include: Staying away from extreme heat and cold. […] Don’t smoke.

• #69 Polycythemia Vera: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17742-polycythemia-vera

  Polycythemia vera is a chronic condition with no cure, but medical care can help you manage symptoms and the risk of complications. […] In addition to regular testing and treatment, your healthcare provider will likely recommend general lifestyle changes to help prevent blood clots and other complications. For example: Exercise. Even moderate exercise can help improve sluggish circulation. […] The most significant threat from polycythemia vera isnt from cancer itself, but from the risk of blood clots. If youre living with PV, make sure to see your healthcare provider regularly. And dont neglect taking care of yourself in the little ways healthy lifestyle habits that can help maintain your general cardiovascular health, which might turn out to be just as important as any medical treatment for polycythemia vera.

• #70 Reducing Cardiovascular Risk in Patients With Polycythemia Vera

  https://www.ajmc.com/view/reducing-cardiovascular-risk-in-patients-with-polycythemia-vera

  Similarly, ESC/European Atherosclerosis Society (EAS) recommend treatment of dyslipidemias with a target of 50% reduction low-density lipoprotein cholesterol (LDL-C) levels. However, lifestyle medications should be introduced as the first line of treatment, including diet, weight, and smoking factors. […] Lastly, in the prevention of thrombotic events, recommendations include prior cytoreductive therapy and anticoagulant therapy for individuals with PV and prior thrombotic events. In the case of no prior thrombotic events, treatment recommendations include a hematocrit (Ht) target of less than 45%, acetylsalicylic acid (ASA) of 40-100 mg per day, and cytoreductive therapy for high-risk PV. […] Strict control of CV risk factors, in association with appropriate hematological therapy, may improve outcomes of patients with Ph-MPN [Ph-positive MPN].

• #71 Vaquez Disease polycythemia Vera | Jules Bordet Institute

  https://www.bordet.be/en/vaquez-disease-polycythemia-vera

  Vaquez disease, or polycythemia vera, is a rare chronic disease of the blood that causes the bone marrow to produce an excess of red blood cells. This thickens the blood, increasing the risk of blood clots (thrombosis) and can cause symptoms such as headaches, redness of the skin, dizziness or severe itching after a hot shower. […] The treatment aims to reduce the excess of red blood cells and prevent complications. It includes regular withdrawing of blood (phlebotomies), medicinal treatment to reduce the blood cell production and antiaggregants and/or anticoagulants to reduce the risk of blood clots. […] If you have Vaquez disease please follow your doctors recommendations and adopt a healthy lifestyle. Avoid cardiovascular risk factors such as smoking or a sedentary lifestyle and follow a balanced and varied diet that is low in cholesterol and salt.

Zobacz więcej