Polycythemia interventions: Difference between revisions

Jump to navigation Jump to search
Line 4: Line 4:


==Overview==
==Overview==
*Phlebotomy: 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 hyper-viscosity 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 polycythemias, 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>


==Indications==
==Indications==

Revision as of 16:58, 24 January 2021

Polycythemia Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Polycythemia from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography or Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Interventions

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Polycythemia interventions On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Polycythemia interventions

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Polycythemia interventions

CDC on Polycythemia interventions

Polycythemia interventions in the news

Blogs on Polycythemia interventions

Directions to Hospitals Treating Polycythemia

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]

Overview

Indications

  • Phlebotomy: 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 hyper-viscosity 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 polycythemias, 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]

References

  1. Assi TB, Baz E (2014). "Current applications of therapeutic phlebotomy". Blood Transfus. 12 Suppl 1: s75–83. doi:10.2450/2013.0299-12. PMC 3934278. PMID 24120605.
  2. "StatPearls". 2020. PMID 30252337.

Template:WH Template:WS