From the Guidelines
In patients with Polycythemia Vera (PV), initial phlebotomy is recommended to be performed weekly or twice weekly until the hematocrit target is reached, with the goal of maintaining the hematocrit below 45% 1.
Key Considerations
- The phlebotomy regimen should involve removing 300 to 450 ml of blood per session 1.
- The frequency of phlebotomy may vary depending on the individual patient's response to treatment and their hematocrit levels.
- Aspirin 81-100 mg daily is often prescribed in conjunction with phlebotomy to reduce the risk of thrombosis 1.
Maintenance Phase
- Once the hematocrit target is reached, the phlebotomy intervals should be determined by the levels of hematocrit, with the same amount of blood volume removed per phlebotomy as in the induction phase 1.
- The goal is to maintain the hematocrit below 45% while minimizing the risk of iron deficiency.
- Phlebotomy may be performed less frequently, such as every 4-6 weeks, to maintain the desired level.
From the Research
Frequency of Initial Phlebotomy in Patients with Polycythemia Vera (PV)
- The frequency of initial phlebotomy in patients with PV is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- However, study 3 mentions that a fixed volume of 350 ml phlebotomy was performed every three days until the desired hematocrit was achieved.
- The goal of therapeutic phlebotomy is to maintain a hematocrit of less than 45% in patients with PV, as stated in studies 2, 4, 5, 6.
- Study 5 recommends phlebotomy to keep hematocrit below 45% and once-daily or twice-daily aspirin (81 mg) for all patients with PV.
- The frequency of phlebotomy may vary depending on the individual patient's response to treatment and their specific needs, but a standard protocol is not clearly defined in the provided studies.