Cytoreductive Therapy

Over time cytoreductive therapy is required in most patients with PV. The PVSG-01 trial raised grave concerns over the increased incidence of acute leukemia with either chlorambucil or 32P, and these agents are seldom used now. However, since 32P and busulfan (an alkylating agent similar to chlorambucil) are given intermittently, they can be useful in the elderly, where regular clinic attendance or drug compliance may be a problem. The main goal in the treatment of PV following the initial findings of the PVSG has been to find a cytoreductive agent that is both safe and well tolerated.

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