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Primary Polycythemia

  • Amy Scholten, MPH
Publication Type:


Primary Polycythemia

(Polycythemia Vera [PCV]; Polycythemia Rubra Vera [PRV]; Erythremia)


Polycythemia is a condition of the bone marrow. It makes too many red blood cells and platelets. Sometimes, white blood cells are affected. The increase of blood cells can make the blood thicken and clot.

Early treatment lowers the risk of serious problems.

Location of Active Bone Marrow in an Adult.

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This condition is caused by changes to a gene. It is not clear what causes this to happen.

Risk Factors

Polycythemia is more common in men and people 40 years of age and higher. The risk is higher in people of Ashkenazi Jewish decent.


Some people with polycythemia have no symptoms. Others may have symptoms such as:

  • Night sweats or hot flashes
  • Reddish skin color
  • Burning feeling in feet and hands
  • Weight loss
  • Bone pain or headaches
  • Dizziness, tiredness, or weakness
  • Problems with breathing, vision, or thinking
  • Ringing in the ears—tinnitus

Blood clots increase the risk of a heart attack or stroke.


Polycythemia is sometimes found during a routine blood test. The doctor will ask about symptoms and past health. A physical exam will be done.

Tests may include:


Treatment depends on how severe the disease is. The goal is to manage the disease and problems linked to it—such as blood clots. For some, a mix of treatments works best.

Options may be:

  • Medicines such as:
    • Low-dose aspirin—to reduce the risk of blood clots
    • Chemotherapy—to lower blood cell production, control blood thickness, and improve the immune system.
    • JAK inhibitors—to reduce spleen size and improve the balance of other blood cells
    • Ropeginterferon alfa-2b—to boost the immune system
  • Blood taken from the veins at times—to lower the amount of red blood cells
  • Surgery to remove the spleen—if it is causing problems


There are no guidelines prevent polycythemia.





  • Mesa, R.A. Refining the management of polycythemia vera. Clin Adv Hematol Oncol. 2018; 16 (9): 587-589.
  • Polycythemia vera. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/polycythemia-vera.
  • Polycythemia vera. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/hematology-and-oncology/myeloproliferative-disorders/polycythemia-vera.
  • Polycythemia vera. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health/polycythemia-vera.
  • 5/25/2022 EBSCO DynaMed Systematic Literature Surveillance https://www.dynamed.com/condition/polycythemia-vera: FDA approves treatment for rare blood disease. US Food and Drug Administration website. Available at: https://www.fda.gov/news-events/press-announcements/fda-approves-treatment-rare-blood-disease.


  • Nicole Meregian, PA
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.