Korean J Blood Transfus.
2013 Dec;24(3):265-274.
Assessment of Effects of Phlebotomy in Patients with Polycythemia Vera and Secondary Polycythemia
- Affiliations
-
- 1Department of Laboratory Medicine, Center for Diagnosic Oncology, National Cancer Center, Goyang, Korea. ksy@ncc.re.kr
- 2Hematology-Oncology Clinic, Center for Specific Organs Cancer, National Cancer Center, Goyang, Korea.
- 3Center for Lung Cancer, National Cancer Center, Goyang, Korea.
- 4Neuro-Oncology Clinic, Center for Specific Organs Cancer, National Cancer Center, Goyang, Korea.
Abstract
- BACKGROUND
Polycythemia vera (PV) is a myeloproliferative neoplasm that can cause complications such as thrombosis and organ damage. To prevent complications of PV, therapy for maintenance of a hematocrit target of less than 45% has been recommended and phlebotomy is a simple therapy. However, the effects of phlebotomy have not been well evaluated in Korea. Therefore, we evaluated the effects of phlebotomy performed in patients with PV and secondary polycythemia.
METHODS
The clinical data and phlebotomy records of 15 patients diagnosed with PV and secondary polycythemia from May 2005 to March 2013 at the National Cancer Center were reviewed retrospectively.
RESULTS
Patients included 10 males and five females. The median age of patients was 63 years (range, 50~72 years). There were six PV patients (40%) and nine secondary polycythemia patients (60%). The mean number of phlebotomy attempts per patient was 6 (range, 1~22), with an interval between phlebotomy attempts of 16 weeks (range, 1~96 weeks). The mean phlebotomy volume was 458 mL, which was 10.3% of the total blood volume. After phlebotomy, the mean hematocrit showed a decline, from 50.4 (+/-4.35)% to 46.5 (+/-4.85)%, and symptoms improved. After phlebotomies, 10 patients achieved a hematocrit of less than 45% and this hematocrit level was obtained after an average of six phlebotomies.
CONCLUSION
Phlebotomy is an effective treatment modality for lowering the hematocrit value in patients with PV and secondary polycythemia. However, target hematocrit was not achieved after a single phlebotomy. Therefore, adjustment of visit intervals and changes in phlebotomy volume were needed.
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