Abstract
Since 1903 when polycythemia vera was designated by Osler as a new identity the clinical manifestations at the time of diagnosis--symptomatology, physical and hematological findings have become well known. Criteria for diagnosis have been established as well as treatment goals. However, agreement on how best to treat this disease has eluded the hematologists particularly as our understanding of the evolution of the hematological findings has become better known. The hemorrhagic and thrombotic complications and acute leukemia in patients managed with myelosuppressive regimens have come to the forefront. Criteria to be used in the comparison of treatment regimens are suggested from which in this author's opinion the use of 32P becomes the treatment of choice, but not all will agree.