Journal of Hong Kong College of Radiologists

Volume 4 Number 2, 2001

Treatment of Polycythemia Vera: A Clinical Oncology Perspective

CC Tong
Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong

Polycythemia vera is a clonal myeloproliferative disorder. The Polycythemia Vera Study Group was established in 1967; its earliest accomplishment was to create a set of diagnostic criteria for polycythemia vera that have since proven their value. The Polycythemia Vera Study Group then spent almost 30 years conducting sophisticated clinical trials documenting a variety of therapeutic approaches for polycythemia vera, principally phlebotomy alone, or myelosuppression [with either radiophosphorus, an alkylating agent (chlorambucil), or hydroxyurea] combined with supplemental phlebotomy. With current management, survival of patients with polycythemia vera improves dramatically compared with historical controls treated with phlebotomy alone. Today, most clinicians will treat younger patients with polycythemia vera with hydroxyurea. The drawbacks are that this drug has to be taken regularly and the patient must scrupulously adhere to the schedule. For elderly patients with polycythemia vera, management by phlebotomy alone carries a high risk of early thrombosis; radiophosphorus remains the treatment of choice for these patients. (J HK Coll Radiol 2001;4:122-127)

Key words : Phlebotomy, Polycythemia vera, Radiophosphorus, Treatment

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