Blood Treatments for Myeloproliferative Disorders

NYU Langone doctors may recommend different blood treatments to people with polycythemia vera and myelofibrosis.

Polycythemia Vera

Because polycythemia vera causes increased red blood cell levels, the blood may become thickened and clot easily. Phlebotomy, which is the removal of blood, can help lower the number of red blood cells in the body. This reduces the risk of clotting and its possible complications, such as deep vein thrombosis, pulmonary embolism, and stroke.

Phlebotomy

The aim of phlebotomy is to reduce a personโ€™s hematocrit, which is the percentage of red blood cells found in the blood, to healthy levels. This should be 45 percent in men and 42 percent in women to avoid clotting.

In this procedure, blood is removed from the body through a needle inserted into a vein in the arm. The needle is attached to a hollow tube, or catheter, connected to a plastic bag, where the blood collects. The procedure used for phlebotomy is the same as for donating blood.

Your doctor decides how much and how often blood needs to be drawn. Phlebotomy may occur as often as every few weeks or months.

If phlebotomy does not lower hematocrit enough, doctors may prescribe medications instead. Some people may prefer medication to repeated phlebotomy.

Primary Myelofibrosis

People with primary myelofibrosis who also have significant scarring of the bone marrow may need blood transfusions to restore and maintain healthy blood cell levels.

Blood Transfusions

Blood transfusions are given as an intravenous (IV) infusion through a catheter inserted into a vein in the arm. They can last for several hours and are used as often as once or twice a week.

The procedure is generally safe, but repeated transfusions can cause allergic reactions or a buildup of iron in the body, which can damage the liver, heart, or pancreas.

To manage high iron levels, doctors can prescribe chelating agents, which help rid the body of extra iron through the urine or stool. They are given as an infusion over several hours for a few days a week or in pill form, taken daily by mouth for a period of time determined by your doctor.

People with myelofibrosis may need psychological support, supportive care, and integrative health therapies to help them cope with ongoing blood transfusions.

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