From the Guidelines
The medical term for thick blood requiring phlebotomy is Hemochromatosis, specifically referring to a condition where iron accumulation leads to increased blood viscosity and potential organ damage, as described in the 2022 EASL clinical practice guidelines on haemochromatosis 1. This condition occurs when there is an excessive accumulation of iron in the body, leading to increased blood viscosity and potential organ damage. The most common form is Hereditary Hemochromatosis (HH), a genetic disorder that causes increased iron absorption. Treatment primarily involves therapeutic phlebotomy, where blood is regularly removed to reduce iron stores and blood viscosity. According to the 2022 EASL guidelines, phlebotomy should be performed weekly or fortnightly during the induction phase until iron stores are depleted, with a target serum ferritin of 50 lg/L, and then maintained in the range of 50-100 lg/L during the maintenance phase 1. Additional considerations include monitoring serum hemoglobin levels to avoid anemia and adjusting phlebotomy frequency accordingly, as well as periodically checking plasma folate and cobalamin levels to prevent deficiencies. Regular monitoring of serum ferritin levels is also crucial to ensure that the target value is achieved and maintained, and to avoid overtreatment or iron deficiency, as recommended by the 2022 EASL guidelines 1. This condition requires treatment because excessive iron accumulation increases the risk of liver disease, heart problems, and other complications due to impaired organ function. Key aspects of management include:
- Regular phlebotomy to reduce iron stores and blood viscosity
- Monitoring of serum ferritin and hemoglobin levels to guide treatment
- Maintenance of serum ferritin levels within the target range of 50-100 lg/L
- Prevention of iron deficiency and anemia through careful monitoring and adjustment of phlebotomy frequency.
From the Research
Medical Term for Thick Blood
The medical term for thick blood is polycythemia vera (PV), a myeloproliferative neoplasm characterized by an increased red blood cell mass and increased risk of thrombosis 2.
Need for Phlebotomy
Phlebotomy is a treatment for PV, which involves removing blood from the body to reduce the risk of thrombosis 3, 2, 4, 5. The goal of phlebotomy is to maintain a hematocrit of less than 45% 2.
Key Points
- PV is associated with an increased risk of arterial and venous thrombosis, hemorrhage, myelofibrosis, and acute myeloid leukemia 2.
- Phlebotomy and low-dose aspirin are recommended for all patients with PV 2.
- Cytoreductive therapies, such as hydroxyurea or interferon, are recommended for patients at high risk of thrombosis 3, 2, 6.
- The need for phlebotomy under hydroxyurea therapy identifies a subset of patients with increased proliferation of PV and higher risk of thrombosis 4.
- Phlebotomy and hydroxyurea are associated with improved overall survival and decreased risk of thrombosis in older patients with PV 5.