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KMID : 0387720130240030265
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Korean Journal of Blood Transfusion
2013 Volume.24 No. 3 p.265 ~ p.274
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Assessment of Effects of Phlebotomy in Patients with Polycythemia Vera and Secondary Polycythemia
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Kong Jung-Hee
Lee Se-Na
Eom Hyeon-Seok
Lee Hye-won
Han Ji-Youn
Yoo Heon
Shim Hyo-Eun
Kong Sun-Young
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Abstract
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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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KEYWORD
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Polycythemia, Phlebotomy, Hematocrit
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