Phlebotomy with goal hematocrit < 45%
Patients with severe plethora, with AMS or vascular compromise can be bled vigorously with removal of 500 mL of whole blood rapidly
Otherwise, gradual phlebotomy of 500-1000 mL over 24 hours is preferred in less emergent cases
ASA 81mg
Myelosuppressive agents (hydroxyurea, interferon-α)
If presenting with hyperviscosity syndrome:
IVF and plebotomy
Patients with severe plethora, with AMS or vascular compromise can be bled vigorously with removal of 500 mL of whole blood rapidly
Otherwise, gradual phlebotomy of 500-1000 mL over 24 hours is preferred in less emergent cases
IVF and plebotomy
Polycythemia vera
Primary polycythemia 
Aplastic anemia
Essential thrombocytosis
Essential thrombocytosis 
Myelofibrosis
Chronic myelogenous leukemia 
Immune thrombocytopenic purpura