Phlebotomy for Polycythemia Vera: Prognosis & Side Effects

Read more about Therapeutic Phlebotomy for Polycythemia Vera. In addition, this article highlights Prognosis, Treatment Guidelines for Polycythemia, or erythrocytosis.

Side Effects of therapeutic phlebotomy in addressing this condition are also examined. Finally, I touch briefly on the PV life expectancy.

What is Polycythemia?

Polycythemia describes a significant increase in the mass of the red blood cells within the bloodstream. It may be split into absolute polycythemia or relative polycythemia.

By definition, absolute polycythemia is an increased number of red cells. On the other hand, relative polycythemia is the result of a reduction in the volume of plasma through processes such as vomiting.

The condition may be presumed in an individual having an increased hemoglobin level (over 18.5 g/dL in men or 16.5 g/dL in women), an increased hematocrit (over 52 percent in men or 48 percent in women), or an increased red blood cell count.

Note: It should be noted that absolute polycythemia is usually split into primary polycythemias, (that includes polycythemia Vera), as well as secondary polycythemia.

Polycythemia Prognosis

In most cases, the survival of Polycythemia Vera Patients that receive modern treatment is actually decades-long.

However, symptoms, additional complications, and hematologic alteration result in considerable morbidity and reduced life expectancy.

Although not a curative modern therapy for PV, it can alleviate signs or symptoms and even lengthen survival.

The targets associated with care are to prevent bleeding events, ameliorate the symptom burden, prevent first and repeated thrombosis, and reduce the risk of progression to severe myeloid leukemia/Myelodysplastic syndrome and post-PV myelofibrosis (MF).

While no drug is shown to reduce the risky likelihood of hematologic transformation to MF, existing treatment techniques normally steer clear of agents capable of elevating this particular risk.

Therapeutic phlebotomy Guidelines & Procedure

Guidelines for therapeutic phlebotomy for polycythemia, in this case, relate to guidelines for the control of the hematocrit levels.

There isn’t any accurate guideline regarding the optimum hematocrit level in individuals having PV.

Several studies recommended maintaining hematocrit within levels under 45% for you to reduce the potential risk of vascular occlusive episodes.

Other studies showed the reduction of the hematocrit to an average of 45.5% was linked with a reduction in the viscosity of the whole blood. Also, there was an excellent improvement in cerebral blood circulation.

Reasons for therapeutic phlebotomy

Therapeutic phlebotomy qualifies for 3 major reasons namely:

  1. Polycythaemia vera,
  2. Hemochromatosis
  3. Porphyria cutanea tarda.

It’s recently been deployed as a treatment option for several other illnesses in several nations around the world, particularly in Chinese medicine, even though western medical care may not accredit most of these indications.

Therapeutic Phlebotomy Side effects

Phlebotomy is currently regarded as the pillar of Polycythemia Vera treatment. The big question is what are the side effects of phlebotomy for polycythemia?

Adverse reactions which could occur soon after therapeutic phlebotomy are similar to those following any kind of blood donation.

The primary difference is the fact that phlebotomy is performed more often than voluntary blood donation and for that reason affected individuals generally report getting worn out (fatigue) as well as light-headed immediately after a number of sessions.

A deficiency of iron can develop, but it’s often moderate self-limiting anemia. Therefore, this means iron supplementation is not required unless, of course, it gets symptomatic.

Some of the major side effects include:

  1. Vasovagal reactions
  2. Arm bruises & soreness,
  3. Fatigue,
  4. Nausea and vomiting
  5. Hematoma


  • Therapeutic phlebotomy has got several limitations. These include: patients may well be illiberal, or they often have a decreased acceptance of it, and it will be a challenge to get access to the peripheral vein.
  • There isn’t any absolute contraindication provided. However, the relative contraindications consist of serious cardiovascular disease and anemia.

Secondary Polycythemia Treatment & Drugs

According to MayoClinic phlebotomy treatment for polycythemia vera may include:

#1 Low-dose aspirin

A medical expert may suggest that you have a low dosage of aspirin to lower blood-clots risk. Lower doses of aspirin may also be helpful in reducing the burning discomfort in the hands or feet.

#2 Drawing blood from your veins

Taking blood from your blood vessels in the process known as phlebotomy is often the primary treatment method for individuals with polycythemia vera.

Therapeutic phlebotomy cuts down the number of blood cells and reduces the blood volume.

This means it tends to make it simpler for the blood to perform its functions effectively. How frequently you’ll need therapeutic phlebotomy is determined by the seriousness of the condition.

#3 Medications to lower the number of blood cells

For those who have polycythemia vera, and aren’t assisted through phlebotomy alone, medicinal drugs, such as hydroxyurea can be used to restrain the bone marrow’s capability to generate blood cells.

Interferon alpha enables you to stimulate the immune system to battle red blood cell overproduction. It may be useful for those who do not interact well with hydroxyurea.

This drug has undergone numerous clinical trials to assess its effectiveness.

#4 Therapies to relieve itchiness

For those who have annoying itchiness, a medical expert may recommend medications, which include antihistamines. They may also encourage ultra-violet light therapy to alleviate your pain.

#5 Medications to destroy cancer cells

Jakafi (also known as Ruxolitinib) meets the approval of the Food and Drug Administration to take care of individuals with polycythemia vera that don’t interact properly with hydroxyurea.

It can help the body’s defense mechanism eliminate cancer cells. In addition, it can easily eradicate some Polycythemia Vera signs or symptoms.

Polycythemia Vera Treatment Diet

Patients with PV should modify their dieting or nutrition behavior. Below are some of the suggestions for a Polycythemia Vera Treatment Diet.

Take a Low-Sodium Diet

You must watch your consumption of sodium salt. Elevated blood volume will increase the likelihood of hypertension. Restricting the sodium taken in may help you handle your blood pressure level effectively.

The initial step in lessening the sodium consumption will be to quit adding sodium salt into your meals while preparing food and also at the table.

Second, one should reduce their consumption of high-sodium junk foods, including deli meat, bacon, frozen meals, sausage, salted chips, and soup. As an alternative, incorporate fresh, whole foods prepared at home with salt-free spices.

Ensure the Diet is Well-balanced

Sustaining a well-balanced diet is essential for bodyweight maintenance for those who have polycythemia.

A well-balanced diet plan is designed to offer you the correct amount of calories, vitamins, protein, and minerals your body system requires to work effectively while keeping a proper body weight.

A medical expert or perhaps nutritionist may help you figure out your own needs.

Generally, a well-balanced diet incorporates a selection of nutrient-rich food items from each one of the recommended food groups, which include fresh fruits, veggies, whole grain products, lean proteins, and low-fat dairy products.

Take note of Iron in Food

Should you undertake phlebotomy as the form of treatment for polycythemia, it’s possible you’ll be worried about an iron deficiency. Worry not!

Even though your blood might be lower in iron than usual, individuals with polycythemia usually do not endure the conventional signs and symptoms of iron deficiency.

Additionally, inducing a chronic condition of iron deficiency may help those with polycythemia by decreasing the production of blood.

Polycythemia Vera 20 Years

The life expectancy of Polycythemia Vera is a highly debated subject. What is important here is for patients to engage in regular monitoring.

This is a rare disease or complication and, therefore, close follow-up is recommended. For those who receive proper care after diagnosis, a life expectancy of about 20 to 40 years is achievable.