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

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.