What is your experience managing myelosuppression from busulfan, prescribed for PV?

I have no direct experience managing busulfan-induced myelosuppression in PV but I do have experience in managing busulfan-induced aplastic anemia. To begin with, busulfan is an alkylating agent and as such is a leukemogen and its use in a chronic myeloproliferative neoplasm should be restricted to ...

I occasionally prescribe busulfan for older patients with PV or ET in whom hydroxyurea and anagrelide are either not tolerated or ineffective. I use it to control the platelet count when patients become symptomatic (typically neurologic symptoms) with platelet counts above 700-800K. To avoid undue m...