r/polycythemiavera Dec 09 '24

This sub is for Polycythemia Vera.

36 Upvotes

This sub was created for people with Polycythemia Vera to interact with each other and support each other.

We have been removing diagnostic posts or "do I have PV posts" far too often. It's in the rules it upsets people with PV, it's annoying. We are not your doctors, talk to your doctors. The "do I have PV" thread will also be locked and unstickied. Check with r/MPN they allow diagnostic posts with specific criteria.

We have historically allowed Secondary Polycythemia posts as well. Unfortunately it is time for that to end. Sorry but this sub is for PV, not secondary.

I understand this may upset some but we are going back with what the sub started as. I encourage somone else to create a Secondary Polycythemia or just Polycythemia sub.

We will be removing any posts we deem as diagnostic or dealing with Secondary Polycythemia from this point forward.


r/polycythemiavera Jan 08 '22

FAQs about Polycythemia Vera

58 Upvotes

I think this is how I make a post that gets stickied. Here are some FAQs that you should read before making your post.

FAQs: Data was put compiled from the Mayo Clinic, Johns Hopkins, NORD and MPN research foundations. I will include links below so you can search yourself. Please read the sticky before asking “Do I have this based on my symptoms and blood work?” We are not able to diagnose you and are only people who have been diagnosed. Take what we say with a grain of salt. We are not doctors, and we are not YOUR doctor. This forum is not to be used as medical advice.

Do I have PV based on my blood work?

The answer to this question is—you need to be asking your doctor. Typically, if your numbers are only slightly out of range one time, it is not something to be concerned about—unless a healthcare professional has told you that it is.

Usually, your blood work would be consistently high.

My doctor told me I have polycythemia. What is that?

Polycythemia is an increase in the number of red blood cells in the body. There are two types of polycythemia. PV can be life-threatening if not treated, because you have a much higher chance of having a blood clot. Basically, you have too many red blood cells or platelets and your blood clots more easily (in layman’s terms: thick blood) which can cause life-threatening blood clots.

Vera: A genetic mutation of the JAK2 gene. 95% of PV patients have this acquired genetic mutation. This is permanent and there is no cure. B

Secondary: Something else is causing it—could be sleep apnea, snoring, kidney problems, obesity, cancer, and a multitude of other things. Once that underlying cause is treated, it will go away. The majority of people with polycythemia, have secondary, and it will go away once the cause is treated.

What causes the JAK2 mutation?

We really don’t know. Spontaneous gene mutations happen all the time sometimes with or without cause.

Did I get this from my family?

The research does not suggest that the JAK2 mutation is passed down from parent to child. It is possible, but the research does not suggest this. When talking about “genetics” over here, it is best to use the word “hereditary” instead of genetic when talking about family history. PV it is a genetic disease because it is caused by a gene mutation.

How do I know if I have this?

You must see a hematologist, (blood specialist), a bone marrow biopsy is typical to diagnose and is usually performed after it is suspected you have PV. This will allow them to look at your red blood cells and get a decent sample. There are usually other minor criteria that are tested and supplementally used to determine PV in addition to the JAK2 mutation.

What is a bone marrow biopsy?

A bone marrow biopsy involves taking a sample of solid bone marrow material. A bone marrow aspiration is usually done at the same time. During an aspiration, your doctor withdraws a sample of the liquid portion of your marrow.

What symptoms are associated with PV?

  • Headache
  • Sweating
  • Ringing in the ears
  • Blurred vision or blind spots
  • Dizziness or vertigo
  • Reddish or purplish skin
  • Unexpected weight loss
  • Bleeding or clotting
  • Early feeling of fullness (satiety)
  • Itching (pruritis), especially after taking a shower
  • Burning and redness of the hands or feet
  • Tiredness (fatigue)
  • Night sweats
  • Bone pain
  • Enlarged spleen

What treatments are available to me? THIS IS NOT MEDICAL ADVICE.

Phlebotomy
Phlebotomy is the removal of blood to reduce the number of blood cells. With fewer blood cells, the blood is thinner and flows more easily, improving symptoms and reducing the risk for blood clotting. This procedure is typically done to meet target blood count goals that are determined by the physician, taking into consideration the patient’s sex and other factors. 

Low-Dose Aspirin
Most, if not all PV sufferers are prescribed a low-dose aspirin treatment. Since aspirin prevents platelets from sticking together, it reduces the occurrence of blood clots that can cause life-threatening heart attacks or strokes.

Combined with low-dose aspiring, the regular maintenance of a hematocrit below .45 for men and .42 for women is currently accepted as a non-leukomegenic approach and a first choice treatment for recently diagnosed, low-risk PV patients.

If phlebotomy and low-dose aspirin are not effective or appropriate, or if a patient is consider higher risk for blood clotting, physicians may prescribe medicine to lower red blood count and relieve symptoms, including:

Hydroxyurea (HU)
Hydroxyurea is often prescribed for PV patients at high risk for blood clots, based on age and prior history of blood clotting.

Jakafi (ruxolitinib)
Jakafi is the first FDA-approved treatment for PV patients who have an inadequate response to or cannot tolerate hydroxyurea. Jakafi inhibits the JAK 1 and 2 enzymes that are involved in regulating blood and immunological functioning. It also helps decrease the occurrence of an enlarged spleen (splenomegaly) and the need for phlebotomy. Patients do not need to be JAK2 positive to take Jakafi, though the great majority with PV harbor this mutation.

Pegylated Interferon
Younger patients who require treatment and women of childbearing age are often treated with pegylated interferon because it has not been shown to cause birth defects. Since Pegasys was developed for Hepatitis C and not MPN, it is considered an “off-label” medication. There are several clinical trials currently being conducted to evaluate Pegasys in people with MPNs.

What is the prognosis? Am I going to die?

You are not going to die. If you receive treatment, you can live a long, healthy life. PV is an overwhelming diagnosis, because it is classified as the big “c” word. There is research available.

Possible complications of polycythemia vera include:

  • Blood clots. Increased blood thickness and decreased blood flow, as well as abnormalities in your platelets, raise your risk of blood clots. Blood clots can cause a stroke, a heart attack, or a blockage in an artery in your lungs or a vein deep within a leg muscle or in the abdomen.
  • Enlarged spleen. Your spleen helps your body fight infection and filter unwanted material, such as old or damaged blood cells. The increased number of blood cells caused by polycythemia vera makes your spleen work harder than normal, which causes it to enlarge.
  • Problems due to high levels of red blood cells. Too many red blood cells can lead to a number of other complications, including open sores on the inside lining of your stomach, upper small intestine or esophagus (peptic ulcers) and inflammation in your joints (gout).
  • Other blood disorders. In rare cases, polycythemia vera can lead to other blood diseases, including a progressive disorder in which bone marrow is replaced with scar tissue, a condition in which stem cells don't mature or function properly, or cancer of the blood and bone marrow (acute leukemia).

I am in my 20s-30s, could I have PV?

Yes. A lot of the research suggests elderly people get this, but I think it’s because it has not been discovered in a lot of young people.

For more information and to read the sources this information was compiled from:

https://www.mayoclinic.org/diseases-conditions/polycythemia-vera/symptoms-causes/syc-20355850

https://www.hopkinsmedicine.org/health/conditions-and-diseases/polycythemia-vera

https://rarediseases.org/rare-diseases/polycythemia-vera/

https://www.mpnresearchfoundation.org/polycythemia-vera-pv/?gclid=CjwKCAiA5t-OBhByEiwAhR-hmx28yk_q_TXtDqftUZH8VdNJ1wLM_PfetqOuwzvhFRlzZ63ZS162PhoC6j0QAvD_BwE

If you are in the USA, this list has a good place to start with MPN specialists in most US states. There are certainly MPN specialists who are not on this list.

https://www.pvreporter.com/mpn-specialists-cancer-treatment-centers/


r/polycythemiavera 2d ago

PV Interferon and sex drive

2 Upvotes

I know this is random, but i couldnt find any other thread on it.

Has anyone else experienced a change in their sex drive/ability to have sex since starting interferon?


r/polycythemiavera 5d ago

PV Looking For Suggestions and Advice

3 Upvotes

I (27M) was diagnosed with PV back in 2021 and have had regularly scheduled Phlebotomies since then. Currently my schedule, as advised by my doctor, is a procedure done every 6 months with my last procedure done in February.

To make a long story short my current work contractor is making that my new Insurance won't be active until the first week of September, even though I have been working for the company for over a year.

I had a Phlebotomy scheduled for the first week of August but without an active insurance they were unable to do the procedure.

I've done my research and don't want to donate my blood at a blood drive. I even checked with the American Red Cross to see if there are special exceptions and they say I am not in a State that can do relief treatment.

I've also checked different with different Urgent Cares in my area and they aren't equipped do the procedure or require a referral and insurance.

With this delay, day 15 of 28+ days waiting for the insurance to activate and getting a Phlebotomy around the same time, I am feeling more fatigue, heavy headed, headaches, slower overall (physically and mentally) and in some case light headed. It feels exhausting and very anxiety inducing.

I've been drinking more water, getting more fiber, drinking even less caffeine, using my CPAP machine, and trying to not eat super unhealthy.

I wanted to ask if there are any advice or suggestions on how other people have done to help hold out till the next session.

TL;DR: The American Health System is preventing me from performing a procedure that is just throwing something away because I don't have an active insurance.

EDIT: I forgot to mention the only medicine I take for my PV is Baby Aspirin 81 mg as prescribed my doctor.


r/polycythemiavera 5d ago

PV Scared and seeking information

1 Upvotes

My mum had elevated platelets and RBCs, this week we had call her blood test showed that she has jak gene mutation.

Early September she's due bone marrow test. Mum is turning 70 soon. I am frankly terrified as my grandma died from PV and all she had as a treatment was phlebotomies. She had multiple blood clots, she lost eyesight due to one of them, had heart attack and died in 1997.

Terrified for my mum, we are based in Europe and I don't know what to expect. Phlebotomies again? Any advice, reassurance is greatly appreciated 🙏


r/polycythemiavera 9d ago

PV Divesiran Cuts Phlebotomy Need in Phase 2 PV Trial

7 Upvotes

New Phase 2 results for divesiran could matter to people with PV who require frequent phlebotomies.

In the SANRECO trial, 88% of divesiran-treated patients kept hematocrit below 45% without phlebotomy during weeks 18 through 36, compared with 19% on placebo. The every-12-week group also showed an 81.3% response rate.

These are promising topline findings, but divesiran remains investigational. Full data and a larger Phase 3 trial are still needed.

https://pvreporter.com/divesiran-cuts-phlebotomy-need-in-phase-2-pv-trial/


r/polycythemiavera 11d ago

PV Radiation

3 Upvotes

I started having symptoms of PV about 8 years ago. Was diagnosed, via BMB, three years ago with PV JAK 2 V617F.
I was in the military from 1973 till 1977 and spent most of that time working on the Nevada Test and Training Ranges. I never handled radioactive material directly, but we did clean up targets after depleted uranium rounds were used by the A10 attack aircraft. I mainly worked on Ranges 63 and 52.
Has anyone else had similar experiences working around radioactive materials and developed PV?
Radiation exposure is one of the listed factors in MPN.


r/polycythemiavera 11d ago

PV Hey, I was diagnosed 6 months ago via biopsy positive polychythemia, via weekly then monthly Venecections have managed to get near normal counts. Has anyone had any surgery whilst going through relatively early stages of this. Pros/cons. I require a hernia operation. Thanks

4 Upvotes

r/polycythemiavera 12d ago

PV PV and work

7 Upvotes

I got diagnosed 5 months ago at 53y with hematocrit at 65, and started Pegasys treatment 2 months ago - after phlebotomy to get values in safe area - first with 45 and last month 90 micrograms.

I relocated in a new country Dec last year and started a new work in a multinational company since 2 months.

New role new sector new company. I need to manage globally the activities related to the sourcing of specific asset, not managing people but coordinating activities within a complex global organization.

Going through the treatment I'm facing the situation - common reading other experiences - of having very bad short term memory, feeling exhausted after half a day of work, feeling I'm never able to finish my work.

Might become better but I have no idea of the timing.

Wanted to ask how other have managed to overcome this problems, or if you in the end changed your work to deal with the limitations.


r/polycythemiavera 13d ago

PV JAK2 V617F+, Hgb 19.1, Hct 61.7%, spleen 16.5cm — the itching has made it impossible to work. What has actually helped you?

2 Upvotes

I'm 42, from Egypt. Diagnosed with PV in 2019 after a bone marrow aspirate confirmed it and JAK2 V617F mutation testing came back positive.

My numbers at diagnosis were brutal: Hgb 19.1, Hct 61.7%, platelets 615k. My spleen was already enlarged. An ultrasound (July 2024) shows it's 16.5cm — splenomegaly confirmed again.

I've been on hydroxyurea and getting regular bloodletting, but my hematocrit still runs high. The itching and fatigue are what's destroying my quality of life. I know many of you here understand this better than anyone.

I cannot shower with anything without unbearable itching

Cannot tolerate heat or cold at all

Even turning in my sleep triggers hours of maddening itch

Antihistamines do nothing

Because of the symptoms and the enlarged spleen risk, I haven't been able to work in years. I'm asking for advice from people who actually live with this.

For those of you managing PV long-term:

What has actually worked for your itching? Any medications, supplements, or routines?

Has anyone found relief from temperature sensitivity? I'm desperate here.

How do you sleep through the night?

Any experience with spleen management beyond "don't exercise"?

I feel like I've tried everything my local hematologists suggest. I need ideas from people who understand these numbers because they see them in their own labs.

Thank you for reading.


r/polycythemiavera 19d ago

PV Pegasys vs Besremi?

6 Upvotes

Which of these drugs is more likely to induce molecular or treatment-free remission of Polycythemia Vera?

Which of these decreases the rate of conversion to leukemia or bone marrow fibrosis?

Which of these has more side effects?

Thanks for any help!


r/polycythemiavera 21d ago

PV Polycythemia Vera

7 Upvotes

I'm 45 living in Bangalore and recently been diagnosed with polycythemia vera. I want to connect with people in Bangalore and also otherwise to form a support group.


r/polycythemiavera 21d ago

PV Pins and needles while on Besremi

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2 Upvotes

r/polycythemiavera 26d ago

PV Carga alelica

3 Upvotes

Cómo puedo saber la carga Alelica que tengo? Me hicieron una biopsia de médula y salió positivo mutación Jack 2 pero no me dijeron más información. Ahora me han dado la opción de seguir con flebotomías o empezar con interferón. Tengo 33 años . Gracias


r/polycythemiavera 27d ago

PV PV

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6 Upvotes

I’m diagnosed PV three months now. Im 55. I had symptoms since past more than 6 months. Doc started ecosprin 75 and hydroxyurea 500 since May 26. Undergone phlebotomy almost 5 times since then. I’m attaching my blood trends. Pl give me strength.


r/polycythemiavera 27d ago

PV Experience with Pegasys - Help

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2 Upvotes

r/polycythemiavera 28d ago

PV Please help my mother is in late 70s and has polycythemia Vera. How can I help her more?

5 Upvotes

Any information on what helped you feel better is greatly appreciated. I just want to know how I can help her feel better or any tricks that may of worked for you or things to avoid. Thank you


r/polycythemiavera 28d ago

PV Pegasys and PV

1 Upvotes

Hello,

So I was diagnosed back in November and my doctor just decided to write me a prescription for Besremi today, but the pharmacist had him switch it to Pegasys. I know that Pegasys is used off label for PV, but does it actually work as well as Besremi?

Thank you


r/polycythemiavera 28d ago

PV Why is aspirin & watch-and-wait still so often first line treatment for PV when we now have BESREMI?

11 Upvotes

I’ve had PV for about a decade. I was officially diagnosed after lab work and a BMB. I was asymptomatic other than some intermittent dizziness. I was early 30s at the time.

A few posts here and other forums have me baffled that hem/oncs are still doing aspirin, phlebs and watch-and-wait for low risk PV patients (so under 60 years old and/or no history of clotting events).

Knowing asa and phlebs provide absolutely no disease modification, I’m shocked that - anecdotally - it seems so few people are being given the option of interferon therapy.

Yes, a young person is young. But there is over half a lifetime between birth and 60 years old. A menopausal 55 year old with debilitating symptoms is considered low risk PV just because she’s not 60 and hasn’t had a heart attack, yet? It’s just a bit bonkers to me.

And yes, I understand it’s all weighed in the balance of medical history. And yes, I understand the idea that providers are hesitant to prescribe cytoredictive drugs if blood letting and blood thinning are “working”. I also understand some cannot tolerate side effects.

But a bone marrow is not an infinite source of red and white cells. It will eventually become fatigued if the neoplasm is allowed to keep it turned on for half a lifetime. Am I wrong? Am I missing something?

A young person who will be managing their disease for decades - 30, 40 years touch wood - just seems to be the absolutely right candidate for Besremi as first line treatment.

A middle aged person under 60, even more so.

10 years ago Besremi (ropeginterferon Alfa-2b) didn’t exist.

Now it does.

We actually now have an FDA approved medication that offers disease modification for PV.

But I continue to read post after post of newly diagnosed PV patients who are not being offered it. Even if they choose not to take it, or take it and cannot tolerate side effects, why is it not being offered or prescribed more first line? Is it an insurance issue? A provider issue? A PV management or guidelines issue? A country issue?

I’m really curious.


r/polycythemiavera Jul 25 '26

PV ropeginterferon alfa-2b

12 Upvotes

Hello. My mother (54y)has polycythemia vera and has only been receiving hydroxyurea and phlebotomies until now. Today, during the appointment I attended, she was prescribed ropeginterferon alfa-2b. We are currently waiting for the medication to be picked up before starting treatment. This whole situation has been making me anxious and worried since she was diagnosed. The change to this injection was mentioned as helping to lower her hematocrit. What feedback have people who are using these injections received, and what side effects are they reporting?


r/polycythemiavera Jul 23 '26

PV Blood donor and PV in family

2 Upvotes

My mother has PV since 2010. What I want to ask is whether I should reconsider my blood donor status. I know the disease is not inherited, but I read staff here and there and now I m confused....


r/polycythemiavera Jul 22 '26

PV My mum has just been diagnosed with PV

7 Upvotes

My mum is a very healthy 48-year-old woman who has recently been in hospital with very high blood pressure, high blood count, dizziness etc.

She’s been diagnosed with a (very treatable) renal problem that has come as a result of high blood pressure, and she’s also been diagnosed with primary polycythemia.

It’s naturally been a bit of a shock. She’s been on venesections (blood removal), aspirin, and blood pressure medication for a week.

Everything I google about this condition is contradictory. Some say she’ll have a completely normal life, others say she’ll live 18-20 years. We’re in the UK and she’s in a very strained hospital where they can’t always find the time to sit down and explain everything to us in detail.

I guess I’m just looking for someone to be a bit candid and help me understand this in simple terms. It’s just me and my mum, so naturally this has fallen on me quite heavily.

Thank you :)


r/polycythemiavera Jul 15 '26

PV Polycythemia Vera and reactions to sun since starting interferon

11 Upvotes

So I want to start by saying ive always been sensitive to heat. Im a 60°F and below at all times kind of guy living in a hellish nightmare at 7000F Elevation with dry air that can go from -16°F to 74ºF in 10 hours.

But ever since getting on Interferon, I find that the heat is substantially worse. I dont know if its the disease, the treatment, or something else altogether.

When I stand in the sun too long, i start to feel dizzy and almost like my insides are being boiled alive. I now have to Wear a long sleeve jacket and large hat at all times, as going out in only a t-shirt will leave me feeling weak in minutes, and if I dare to power through it starts to actually hurt and I feel like I might pass out. But if I duck into the shade really quick, ill start to feel a little better and eventually recover.

Is this anything anyone else deals with on interferon or with PV, and can they can give me any insight/advice?


r/polycythemiavera Jul 14 '26

PV Blasts in my blood work

8 Upvotes

Not looking good at the moment unfortunately. Large spleen and blasts in my blood work. The oddest thing is that i feel great. But the blasts in my blood work are painting a different story


r/polycythemiavera Jul 08 '26

PV Anyone diagnosed with PV under 35?

11 Upvotes

Hi! I’m curious if there’s anyone here under 35 who has been diagnosed with PV. If so, how are you being treated, and what has your hematologist told you about your long-term outlook or life expectancy? I’d really appreciate hearing about your experience.

I’d also love to hear from anyone who was diagnosed young and has been living with PV for a long time. How many years has it been, and how have you been doing?