Hematology: Polycythemia vera — Phlebotomy. Treatment
Polycythemia vera is a type of chronic leukemia characterized by a persistent increase in the number of red blood cells. This slows down the blood flow in the vessels and increases the propensity to thrombosis. To prevent the hemorrhagic complications, the patients are prescribed the procedures aimed at removal of the excessive red blood cells from the body.
Phlebotomy (or bloodletting) is indicated as a primary therapy. The treatment is started when the number of red blood cells is increased by more than 10%. Every 2-3 days, about 0.3 to 0.5 liters of blood is removed. The sessions are continued as long as the hemoglobin level drops to 150 g/l. The missing volume of blood is substituted with plasma-fill solutions.
The blood is taken from the cubital vein, after putting a harness of the patient’s on the shoulder. The puncture is made with Dufaut’s needle. Upon completion of the procedure, a pressure bandage is placed onto the puncture site.
RBCX may become an alternative to phlebotomy. Its essence of which is to purify the blood of the red blood cells outside the body of the patient. The methodology is implemented using special equipment. During the procedure, 500 to 800 ml of blood is taken from the patient. In a centrifugal apparatus, the erythrocytes are extracted from it, after which the purified mass is re-injected into the patient’s bloodstream. 2 to 3 such cycles are usually enough to normalize the blood values.
The treatment is carried out under the supervision of a hematologist. The further advice are developed individually for each case.Hide