Polycythaemia rubra vera

The clinical course of polycythaemia rubra vera (PRV) is marked by a high risk of thrombotic complications and a variable incidence of transformation to myelofibrosis or acute myeloblasts leukaemia. The object of treatment is to minimise the risk of thrombosis and to prevent transformation. The following are used.

Phlebotomy. The object is to reduce the haematocrit to less than 0.45 by venesection (300-500 ml) every 2 days. Thereafter the attempt is made to maintain normal status by occasional venesection. Iron deficiency may occur and need treatment although this may result in a need for more frequent venesection.

Additional myelosuppressive therapy is required in most patients. This is indicated if frequent vene

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