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bloodletting treating polycythemia Vera

J Schwarz, M Penka, V Campr, D Pospísilová, L Kren, L Nováková, C Bodzásová, Y Brychtová, O Cerná, P Dulícek, A Joniásová, J Kissová, Z Korístek, M Schützová, I Vonke, L Walterová
In 2009, the recommendations of the Czech Collaborative Group for Ph- Myeloproliferative Diseases (CZEMP) for diagnosis and treatment of BCR/ABL-negative myeloproliferative diseases (MPD), i.e., essential thrombocythemia (ET), polycythaemia vera (PV) and primary myelofibrosis (PMF) were updated and extended. The present article gives the rationale of the recommendations in full detail. The CZEMP diagnostic criteria for ET and PMF are based on histopathological (HP) findings, which must unconditionally be in line with the given clinical and laboratory characteristics of ET or of a certain stage of PMF, respectively...
February 2011: Vnitr̆ní Lékar̆ství
M A Perazella, M J Bia
A case of posttransplant erythrocytosis in a 51-year-old diabetic man is described. This problem, which can occur in 5 to 15% of renal transplant patients, can result from a contracted plasma volume (diuretics, pressure natriuresis, or glycosuria) or from a true elevation in red blood cell mass. Once the diagnosis of true erythrocytosis is made by a radiolabeled red blood cell mass study, secondary causes such as hypoxia, liver disease, polycythemia rubra vera, renal artery stenosis, and cystic kidney disease should be excluded...
April 1993: Journal of the American Society of Nephrology: JASN
P Boivin
The present report is based on an analysis of the evolution of 720 cases of Polycythaemia vera treated with pipobroman and 624 cases treated with hydroxyurea. General modes of treatment are identical for the two drugs, consisting of initial therapy at relatively high dose aimed at obtaining complete remission and maintenance therapy essential to conserve the improved clinical status. Both types of treatment must be adapted to suit the patient. Complete remission is achieved in 95 to 100% of cases with pipobroman and in 80 to 90% of cases with hydroxyurea...
1993: Nouvelle Revue Française D'hématologie
H P Meyer, R J Slappendel, S W Greydanus-van der Putten
Polycythaemia vera (PV) was diagnosed in a dog by demonstration of an increased red cell mass in association with normal arterial oxygen saturation and the absence of conditions known to be associated with secondary polycythaemia. The dog was treated exclusively by repeated phlebotomies and replacement of the removed volume by colloid and crystalloid solutions. It survived for one year and was generally free of signs.
September 1993: Veterinary Quarterly
R Cimino, V Rametta, C Matera, G Mele, V Mettivier, F Ferrara
We studied the effects of recombinant alpha 2-b interferon (alpha 2-b IFN) in a dose of 3 x 10(6)U intramuscularly three times a week for 1 year in 13 patients affected by polycythemia vera (PV) previously treated with phlebotomy only. Response to treatment was evaluated by reduction of the number of phlebotomies required to retain normal hematocrit value. Ten out of 13 patients (77%) responded to treatment; in 4 of them the exigency of phlebotomy was completely eliminated. In all responders a concomitant decrease of platelet count and splenomegaly was obtained...
November 1993: American Journal of Hematology
D H Cowan, H A Messner, N Jamal, M T Aye, R K Smiley
A 20-year-old woman presented with polycythemia vera and was treated with phlebotomy alone for eleven years, following which all clinical manifestations of the disease disappeared. The clinical remission with normal physical findings and normal peripheral blood counts has persisted for a further 11 years. Erythroid colony culture results have paralleled the clinical state. Initial bone marrow cultures revealed spontaneous growth of erythroid burst-forming units (BFU-E). Subsequent cultures of peripheral blood cells throughout most of the period of spontaneous clinical remission have revealed little or no spontaneous growth of BFU-E...
May 1994: American Journal of Hematology
J D Rain
With the very long life expectancy of Polycythaemia Vera late complications are often observed: progressive resistance to treatment, bad tolerance to maintenance by phlebotomy, progression towards myelofibrosis. Resistance to phosphorus 32 is reflected by a progressive reduction in the duration of remission and by a gradually decreasing remission rate. A complete resistance appears after a mean duration of disease of 7 years. In the maintenance treatment by hydroxyurea, there is a secondary resistance in one third of cases with a poor control of the excess platelets...
April 1994: Nouvelle Revue Française D'hématologie
S Sacchi, P Leoni, M Liberati, A Riccardi, A Tabilio, P Tartoni, C Messora, A Vecchi, L Bensi, S Rupoli
Interferon alpha (alpha-IFN) is increasingly used for the treatment of patients affected by polycythemia vera (PV). As prior studies are difficult to interpret in view of the lack of appropriate controls, we undertook a randomized comparison of lymphoblastoid alpha-IFN (alpha n-1 IFN) treatment against venesection treatment alone. In a crossover trial, we treated 22 PV patients alternatively for 5 months each with 3 MU/day sc of alpha n-1 IFN and phlebotomy alone. During IFN treatment, red blood cell count and hematocrit level were well controlled in both trial groups, reducing or eliminating the need for phlebotomy in all patients; furthermore, platelet number and white blood cell count declined during alpha-IFN therapy...
May 1994: Annals of Hematology
S Bilgrami, B R Greenberg
PV represents a clonal disorder characterized by excessive erythropoiesis accompanied by low serum EPO levels. Two populations of erythroid progenitors have been identified in the BM of patients with PV. One population responds normally to EPO and the other, the malignant clone, is exquisitely sensitive to EPO. The latter phenomenon is regarded as the most readily accepted explanation for the pathophysiology of this disease, although other mechanisms have been proposed. Thrombohemorrhagiccomplications, which usually correlate with the hematocrit level, are the most important because of their frequency and severity...
August 1995: Seminars in Oncology
W G Rector, N J Fortuin, C L Conley
No abstract text is available yet for this article.
November 1982: Medicine (Baltimore)
(no author information available yet)
Between 1967 and 1978 a Phase III cooperative study was performed in polycythaemia vera (PCV) patients who had not been treated previously with any specific therapy other than phlebotomy. 293 patients were included and allocated at random for either radiophosphorus therapy (146) or busulphan treatment (147). Additional phlebotomies were indicated in both groups, to keep the haematocrit at 42-47%. 285 patients were evaluable after the study was completed, of whom 50% have an 8-year follow-up. Both groups were comparable with respect to age, clinical symptoms and haematological parameters immediately before randomization...
July 1981: British Journal of Cancer
A D Watson, J A Yeats
A 7-year-old, crossbred, desexed bitch had a fluctuating illness of more than 6 months duration, with signs of inappetence, reduced exercise tolerance, restlessness, panting, black diarrhoea, and red eyes and ears. Haematological examination disclosed persistent polycythaemia, reticulocytosis, normoblastaemia , and normal total plasma protein concentration when not dehydrated. Splenomegaly was present, but there was no evidence of significant pulmonary, cardiac or renal disease on physical, radiographic or electrocardiographic examination...
February 1984: Australian Veterinary Journal
S Streichman, D Antebi, I Tatarsky
Red cells of polycythaemia vera (PV) patients have a significantly higher rate of electrophoresis than red cells of normal controls and stress polycythaemia patients. The highest increment in the electrophoretic velocity was noted for PV patients treated with phlebotomy or hydroxy urea. The red cells of PV patients treated with 32P and those that progressed to myeloid metaplasia showed a normal rate of electrophoresis. We assume that the increased negative charge found on the red cells of PV patients is typical of the abnormal clone proliferating in this disease...
October 1983: Scandinavian Journal of Haematology
G Birgegård, M Carlsson, B Sandhagen, F Mannting
The relation between whole blood viscosity and iron status was studied in 11 patients with polycythemia vera (PV) who were treated with venesection without iron supplementation. Six were already iron deficient at the start of the study, five were followed from normal iron status to deficiency. Iron status was investigated with serum ferritin, erythrocyte protoporphyrin, mean cell volume and mean cell hemoglobin. There was no correlation between whole blood viscosity at a fixed erythrocyte volume fraction of 44% and any of these variables...
1984: Acta Medica Scandinavica
J M Levin, T L Ostrowski
No abstract text is available yet for this article.
July 8, 1974: JAMA: the Journal of the American Medical Association
W O West
From 1963 to 1983, I treated 100 patients with polycythemia vera, using phlebotomy and the adjunctive agent hydroxyurea. These 78 male and 22 female patients ranged in age from 24 to 88 years (mean 55.7). Duration of therapy ranged from three to 216 months (mean 64.9). The mean daily dose was 0.72 gm, and the median dose was 0.64 gm. Hydroxyurea gave adequate control of red cells, platelets, and spleen size. Cytopenia was not observed. Phlebotomy requirements were markedly reduced. Leukocyte alkaline phosphatase scores were generally lowered and several blood chemistry values returned to normal...
March 1987: Southern Medical Journal
J T Ellis, P Peterson, S A Geller, H Rappaport
The PVSG study is unique in that it is prospective and composed of 432 patients randomized to three treatment arms. This study also provides the opportunity for serial studies of numerous sequential biopsies. Large numbers of cases with sequential biopsies covering the entire long course are essential to appreciate the full spectrum of tissue changes in this disease. The PVSG was initiated in 1967 and in mid-1985 approximately one third of the patients are alive and on protocol. For these reasons, the results must still be considered preliminary...
April 1986: Seminars in Hematology
Y Najean, P Mugnier, C Dresch, J D Rain
Over 20 years, 58 cases of PV in young people (46 meeting the full PVSG criteria, 12 with elevated red cell volume and leucocytosis or thrombocytosis, without splenomegaly) were studied and have been followed for periods of 3-24 years. These cases represent approximately 5% of the cases of PV referred to the Department of Nuclear Medicine of St Louis Hospital during this period. They differ from older patients in the initial clinical severity, the short interval between the first symptoms and the diagnosis, frequent presentation with a life-threatening complication (two cases of hepatic vein thrombosis, six thrombotic or haemorrhagic events, six splenectomies, two abortions) and a very enlarged spleen in half the cases...
November 1987: British Journal of Haematology
W Queisser, M E Heim, J M Schmitz, P Worst
An autosomal erythrocytosis, inherited as a dominant, occurred in seven members of a family. The propositus was first diagnosed as having erythrocytosis at 26 years of age. He had headaches and marked plethora. Polycythaemia vera and secondary erythrocytosis of known cause were excluded. Erythropoietin level was not elevated. Two of his three children were also found to have erythrocytosis. As in this family, the disease is characterized in middle age by hypertension, cardiovascular and thromboembolic phenomena, as well as abnormal bleeding...
May 27, 1988: Deutsche Medizinische Wochenschrift
F Egli, A Wieczorek, M Niemöller, K Rhyner
We analyze symptoms, clinical course, and survival time of 86 patients with polycythemia vera treated between 1966 and 1987 at the medical polyclinic of the University Hospital of Zürich. The mean age of disease onset in 40 men and 46 women studied was 59 years. Most commonly the first symptoms were vertigo and headache (49%) and pain in the extremities (42%). Clinically, plethora was found in half of the cases and 56% showed signs of abnormal arterial and venous circulation. Two thirds of the patients had thromboembolic complications and 40% had hemorrhages chiefly occurring in the gastrointestinal tract...
December 31, 1988: Schweizerische Medizinische Wochenschrift
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