Followup

Full blood counts should be monitored at monthly intervals to assess response, or the need for a new therapy if no response is seen by three months (hematocrit remains above 47%, or continued phlebotomy is required).

The majority of patients show a decline in red cell counts by four to six weeks, to a maximum effect at around three months. If the patient does not respond to P-32 (as mentioned earlier), another mode of therapy should be instituted. The remission may last for six months to two years.

Acute side effects are possible: early side effects are leucopenia and throm-bocytopenia (9), and may need transfusional support. The increased risk of the development of acute leukemia by treated patients should be taken into consideration during follow-up.

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