Polycythemia vera: Essential management protocols

Primary polycythemia (polycythemia vera) is a hematopoeitic stem cell disorder giving rise to proliferation of a clone of hematopoietic precursors leading to an excess production of erythrocytes with thrombocytosis and leukocytosis. The optimum management of polycythemia vera remains elusive. Patients requiring surgery are at increased risk of both perioperative thrombosis and hemorrhage. On one hand, thrombosis can lead to multi organ ischemia and infarction while on the other, bleeding diathesis can lead to profuse perioperative hemorrhage; both posing considerable risk to the patient's health and stress to the anesthesiologist concerned directly with perioperative management of the patient. Hence, management guidelines for polycythemia vera needs to be clearly understood and tailored to each patient individually and appropriate management protocols need to be defined accordingly.