Blood from PV Phlebotomy is NOT Used for Transfusion
Blood removed during therapeutic phlebotomy from polycythemia vera patients is discarded as medical waste and is never used for transfusion to other patients. This is standard practice across all blood banking and transfusion medicine protocols.
Why PV Blood Cannot Be Used for Transfusion
PV is a clonal myeloproliferative neoplasm - The blood contains malignant stem cells with JAK2 mutations (present in >95% of PV patients), making it fundamentally unsuitable for transfusion 1
Blood safety regulations prohibit use of blood from patients with hematologic malignancies - PV qualifies as a myeloproliferative neoplasm, which is an absolute contraindication for blood donation 2, 1
The therapeutic goal is removal, not collection - Phlebotomy in PV aims to reduce hematocrit below 45% to decrease thrombotic risk, with the removed blood serving no therapeutic purpose for others 2, 3
The Purpose of Phlebotomy in PV
Phlebotomy remains the cornerstone treatment for reducing blood viscosity and preventing thrombotic complications in all PV patients 2, 3
Target hematocrit is strictly <45% (approximately 42% for women and African Americans due to physiological differences), which requires regular therapeutic phlebotomy 3, 1
Hyperviscosity from elevated hematocrit causes impaired capillary blood flow, neurological manifestations, and increased risk of both thrombosis and bleeding 4
Common Misconception to Avoid
Do not confuse therapeutic phlebotomy with blood donation - While the mechanical process may appear similar, therapeutic phlebotomy is a medical treatment that produces medical waste, not a donation process 5
PV patients requiring transfusion is paradoxical - Transfusions in PV patients are only indicated in rare circumstances such as perioperative blood loss or transformation to myelofibrosis with cytopenias, and would counteract the therapeutic goal of maintaining low hematocrit 6