KMID : 0387720160270030220
|
|
Korean Journal of Blood Transfusion 2016 Volume.27 No. 3 p.220 ~ p.228
|
|
Optimal Phlebotomy Interval to Change Hematocrit Levels in Patients with Polycythemia
|
|
Lee Hyun-Ji
Shin Kyung-Hwa Song Du-Yeal Lee Sun-Min Kim Hyung-Hoi
|
|
Abstract
|
|
|
Background: Phlebotomy is used to maintain hematocrit levels <45% to prevent polycythemia-related thrombotic events. However, guidelines for the phlebotomy intervals are lacking. Therefore, we analyzed post-phlebotomy changes in hematocrit and determined the optimal phlebotomy intervals for patients with polycythemia.
Methods: Between March 2009 and August 2016, we performed 441 phlebotomies for 48 patients with polycythemia. Patients with high-risk polycythemia vera (PV) or secondary polycythemia with hypertension or arrhythmia were medicated with hydroxyurea. We divided the patients into three groups based on phlebotomy interval <2 weeks, 2¡4 weeks, and >4 weeks.
Results: No patients with secondary polycythemia and 25.8% of the patients with PV had thrombotic events pre-phlebotomy. Post-phlebotomy, none of the patients experienced a thrombotic event. The average decrease in hematocrit level was significantly different between the three groups, being 1.98¡¾1.90% (<2 weeks), 0.73¡¾2.53% (2¡4 weeks), and ?0.46¡¾4.80% (>4 weeks).
Conclusion: To prevent thrombotic events, phlebotomy is a safe and effective treatment to reduce hematocrit levels in patients with polycythemia, regardless of medication. For the maximum effect, a <2-week phlebotomy interval to reduce and <4-week phlebotomy interval to maintain hematocrit levels could be effective.
|
|
KEYWORD
|
|
Polycythemia, Thrombosis, Phlebotomy
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|
|