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How is Polycythemia Rubra Vera Treated?

      Phlebotomy is the term used to describe the removal of blood. Phlebotomy is a good and speedy way of reducing the increased red blood cells down to normal levels. Phlebotomy is the most common therapeutic strategy in polycythemia rubra vera. Physicians have been using phlebotomy for this disease for a long time. Stroke and many other forms of blood clots may occur in polycythemia rubra vera. Phlebotomy reduces the blood volume and viscosity there by decreasing the risk of complications like stroke. The quantity of blood removed at one phlebotomy may be around 400-450cc of which approximately 60 percent are red blood cells. The rate at which polycythemia rubra vera patients may need phlebotomy may vary depending up on the rate of production of red blood cells. Once the blood volume is replete and the viscosity of the blood is normal, the red blood cells can fulfill their function of oxygen delivery to the tissues with better efficiency.

      Some patients may also need treatment with drugs to reduce the red blood cell count, platelet count and white cell count. The medications that are commonly used include hydroxyurea, anagrelide (agrylin), and interferon. Hydroxyurea is a bone marrow suppressant and would suppress production of red cells, white cells and platelets, however the effect on platelet suppression is more pronounce than on red cells and many patients would need a combination of phlebotomy and hydroxyurea. Anagrelide is more specific in decreasing the platelet counts.

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