Polycythemia interventions: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Polycythemia}} | {{Polycythemia}} | ||
{{CMG}}; {{AE}}{{Debduti}} | {{CMG}}; {{AE}}{{Debduti}}{{ZO}} | ||
==Indications== | ==Indications== | ||
*'''Phlebotomy''' is the backbone of therapy, treatment with [[phlebotomy]] alone associated with a longer median survival compared to the use of [[chlorambucil]] or [[radioactive]] [[phosphorous]] based on a trial conducted by [[PV study group]]. Repeated phlebotomies help in [[cytoreduction]] and reduce [[hyperviscosity]] in addition to induce a state of [[iron deficiency]] which can help retard [[red cell]] [[proliferation]]. Weekly sessions are conducted, by remove 500ml of blood until a target [[hematocrit]] of under 45% is obtained. This can lower rates of [[cardiovascular]] deaths and major [[thrombotic]] episodes in patients kept under this threshold based on a trial conducted in Italy. | |||
*For [[secondary polycythemia]], [[phlebotomy]] is usually reserved for the following conditions: | |||
**[[Chronic]] [[lung diseases]] | |||
**[[Cyanotic]] [[heart diseases]] | |||
**Post [[renal transplant]] patients with [[hypertension]] and [[erythrocytosis]], not responding to optimal doses of [[angiotensin-converting enzyme inhibitors]] ([[ACEIs]])/[[angiotensin receptor blockers]] ([[ARB]]) <ref name="pmid24120605">{{cite journal| author=Assi TB, Baz E| title=Current applications of therapeutic phlebotomy. | journal=Blood Transfus | year= 2014 | volume= 12 Suppl 1 | issue= | pages= s75-83 | pmid=24120605 | doi=10.2450/2013.0299-12 | pmc=3934278 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24120605 }} </ref> <ref name="pmid30252337">{{cite journal| author=| title=StatPearls | journal= | year= 2020 | volume= | issue= | pages= | pmid=30252337 | doi= | pmc= | url= }} </ref> | |||
==References== | ==References== | ||
Latest revision as of 18:24, 24 January 2021
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Polycythemia Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Polycythemia interventions On the Web |
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American Roentgen Ray Society Images of Polycythemia interventions |
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Risk calculators and risk factors for Polycythemia interventions |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Debduti Mukhopadhyay, M.B.B.S[2]Zaida Obeidat, M.D.
Indications
- Phlebotomy is the backbone of therapy, treatment with phlebotomy alone associated with a longer median survival compared to the use of chlorambucil or radioactive phosphorous based on a trial conducted by PV study group. Repeated phlebotomies help in cytoreduction and reduce hyperviscosity in addition to induce a state of iron deficiency which can help retard red cell proliferation. Weekly sessions are conducted, by remove 500ml of blood until a target hematocrit of under 45% is obtained. This can lower rates of cardiovascular deaths and major thrombotic episodes in patients kept under this threshold based on a trial conducted in Italy.
- For secondary polycythemia, phlebotomy is usually reserved for the following conditions:
- Chronic lung diseases
- Cyanotic heart diseases
- Post renal transplant patients with hypertension and erythrocytosis, not responding to optimal doses of angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARB) [1] [2]