Evaluation of the efficacy of erythrocytapheresis and phlebotomy in the treatment of polycythemia

BACKGROUND: Systematic comparison of the efficacy and safety of erythrocytapheresis and phlebotomy. RESEARCH DESIGN AND METHODS: A retrospective analysis of 108 polycythemia patients categorized into four treatment groups: 1, 2, or 3 sessions of phlebotomy, and 1 session of erythrocytapheresis. The primary outcome was HGB change. One-way analysis of variance (ANOVA), Kruskal-Wallis H test, t-tests, and linear regression were used to compare efficacies and identify predictive factors, with subgroup analyses for polycythemia vera (PV) and high-altitude polycythemia (HAPC). Linear trend analysis was performed to evaluate the dose-response relationship.The references cited in this article were retrieved through the PUBMED database. RESULTS: A significant difference in HGB change was observed among four groups. 3 sessions of phlebotomy were superior to 1 and 2 sessions. 1 session of erythrocytapheresis achieved comparable HGB change to 2-3 phlebotomy sessions. Linear trend analysis confirmed HGB change increased with phlebotomy sessions. In the PV subgroup, baseline HGB and female gender were predictors of HGB change. In the HAPC subgroup, only baseline HGB was a significant predictor. CONCLUSIONS: 2-3 sessions of phlebotomy are non-inferior to 1 session of erythrocytapheresis in efficacy, with higher safety and cost-effectiveness, and baseline HGB is a universal predictor of therapeutic efficacy.