Is Phlebotomy The Only Treatment Used?
No. In many instances, phlebotomy is used to rapidly bring down the red cell mass and then myelosuppressive drugs are added to, or even replace phlebotomies, as the primary treatment. Some patients do not tolerate phlebotomies or may have such active red cell production that the required frequency of phlebotomy is unacceptable. In addition, some patients have other elevated cell lines such as high platelets or high white cell counts, even before phlebotomy. Some experts use phlebotomy initially but think it speeds the process toward the spent phase. For a variety of reasons, phlebotomy is combined with myelosuppressive therapy to control very active red cell or platelet production, and myeloid metaplasia (the production of blood cells in organs other than the bone marrow). Hydrea and Interferon are the drugs most frequently employed today.
No. In many instances, phlebotomy is used to rapidly bring down the red cell mass and then drugs are added to the treatment plan. Some patients will not tolerate phlebotomies or may have such active red cell production that the required frequency of phlebotomy is unacceptable. In addition, some patients have other elevated cell lines such as high platelets or high white cell counts. Some experts use phlebotomy initially but think it speeds the process toward the spent phase. For a variety of reasons, Phlebotomy is combined with myelosuppressive therapy to control very active erythrocytosis, thrombocytosis or myeloid metaplasia. Hydrea and Interferon are the drugs most frequently employed today and if elevated platelets are a problem, anagrelide may be used.
