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Polycythaemia vera is a myeloproliferative neoplasm causing excess red cell production and an increased risk of thrombosis.
Quick Answer
Polycythaemia vera is a myeloproliferative neoplasm causing excess red cell production and an increased risk of thrombosis. Dr. Sachita Baniya (NMC 20158, 8+ years of clinical experience in haematology and haemato-oncology) evaluates polycythaemia vera at Kathmandu Neurology Clinic & Cognitive Center, 117 Lal Durbar Marg, Kathmandu, Bagmati Province 44600, Nepal — evidence-based, medically reviewed.
PV is usually driven by a JAK2 mutation. It can cause headache, itching, fatigue, plethora and splenomegaly. Management aims to lower haematocrit, reduce thrombosis risk and monitor for progression to myelofibrosis or leukemia.
The WHO criteria use haemoglobin or haematocrit thresholds, marrow findings and JAK2 mutation status. Serum erythropoietin and red cell mass may help in selected cases.
Phlebotomy targets a haematocrit below 45%. Low-dose aspirin reduces thrombosis risk in most patients. Cytoreduction with hydroxyurea or other agents is used for high-risk disease or uncontrolled counts.
Management is individualized and discussed with benefits, limitations, and follow-up.
Control cardiovascular risk factors, stay hydrated and avoid smoking. Adherence to phlebotomy and medication is important.
Red flags — seek urgent care
It is usually a chronic condition managed with phlebotomy and medication. It is not generally curable, but complications can be reduced.
Higher haematocrit increases blood viscosity and clot risk. Treatment aims to keep it below the target set by the treating team.
Low-dose aspirin reduces arterial thrombosis risk in most patients with PV. Bleeding risk is considered before starting.
It is considered for high-risk disease, prior thrombosis, uncontrolled counts, symptomatic splenomegaly or intolerance to phlebotomy.
Yes. Aquagenic pruritus is common and can be distressing. Treatment of the underlying disease and supportive measures may help.
Pregnancy requires specialist planning because of thrombosis and bleeding risks. Treatment is individualised.
A small proportion of patients progress to myelofibrosis or acute leukemia. Regular monitoring helps detect progression.
Regular blood counts, haematocrit monitoring, clinical review and cardiovascular risk management.
Specialist assessment for abnormal blood counts, anaemia, low platelets, bleeding, clotting and suspected blood disorders.
Care for polycythaemia vera, essential thrombocythaemia and primary myelofibrosis.
Assessment and management of venous thromboembolism and cancer-associated thrombosis.
Myeloproliferative neoplasms are clonal marrow disorders with overproduction of blood cells and a risk of thrombosis and progression.
Essential thrombocythaemia is a myeloproliferative neoplasm causing persistently high platelets and a risk of thrombosis or bleeding.
Primary myelofibrosis is a myeloproliferative neoplasm with marrow fibrosis, splenomegaly and progressive cytopenias.
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Reviewed by Dr. Jitendra Prasad Yadav • Last reviewed: 2026-11-10
Content is educational and aligns with standard medical references; individual evaluation may vary. External links provide context and do not imply endorsement.
Doctor — medically reviewed
Dr. Sachita Baniya
Consultant Haemato-Oncologist & Clinical Hematologist • MBBS, FCPS (Clinical Haematology) • NMC 20158
This condition guide was medically reviewed by Dr. Sachita Baniya.
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