Therapeutic Application of Cytoreduction Erythrocytapheresis - Five-year Experience

Overview

During the period 1995-2000 the Haematological Centre of the Faculty Hospital Ostrava-Poruba implemented 208 cytoreduction erythrocytapheresis in 98 patients. The indications were polycythemia vera, secondary polyglobulia, polyglobulia of obscure etiology, haemochromatosis, In one patient erythrocytapheresis was used as a form of haemodilution in a thrombophil condition associated with hyperviscosity due to erythrocytosis. The procedures were implemented in all instances on a continuous separator of blood elements from two peripheral venous approaches. Blood coagulation in the extracorporeal circulation was ensured by citrate solution ACD-A. Three times on account of insufficiency of the superficial venous system venepuncture had to be repeated. In one patient the authors recorded a precollapse state during collection. Manifestations of the citrate reaction were not present in any patient. As compared with classical phlebotomy, cytoreduction erythrocytapheresis ensures safe sampling even of a large erythrocyte volume (as much as 1500 ml) within a short time interval with minimal devastation of the venous system by venepunctures, without losses of plasma proteins, thrombocytes, coagulation factors and without the risk of the vasovagal reaction in conjunction with a decline of the circulating blood volume. It makes it possible to prolong the intervals between erythrocyte sampling, to optimalize within a short time rheological properties of blood, adjust symptoms of dextrolateral cardiac failure associated with polyglobulia and eliminate subjective complaints of the patients.

Key words:
polyglobulia - polycythemia - polycythemia vera - secondary polyglobulia - erythrocytapheresis - phlebotomy