A Study of Hematological Complications Occurring in Patients with Polycythemia Vera Treated with 32P (Based on a series of 296 patients)

Abstract

Abstract Three hundred and three patients with polycythemia vera have been treated with 32P more than five years ago. Seven patients have been excluded because they have been treated by 32P elsewhere before their first visit. Of the 296 other patients, 269 have been followed up regularly for more than 5 years. The median survival after hematologic diagnosis is 14.5 years. It is shorter in older patients and in those patients who had the shortest remissions after the initial 32P treatment. Of 145 patients who had died, death was due in 53 cases to hematologic complications (29 acute leukemia, 4 chronic leukemia, 16 myeloid metaplasia or myelofibrosis, 4 aplastic anemia). The latter complications were seen most commonly in those patients who had received the highest total dose of 32P, those with a high initial white count and those in whom the spleen was palpable at least 2 cm. beneath the costal margin. The influence of the quantity of 32P given is very significant for equivalent clinical situations, the influence of white cell count and spleen size is significant for equal doses of 32P. This suggests that these two types of factors favor the early occurrence of hematologic complications.