THERAPEUTIC ERYTHROCYTAPHERESIS VERSUS TRADITIONAL PHLEBOTOMY IN THE TREATMENT OF PATIENTS WITH ERYTHROCYTOSIS.

Background: - Traditional phlebotomy is the most commonly used therapy for erythrocytosis. After the introduction of the new modality of therapy of cell separators, erythrocytapheresis has been also introduced. The aim of the study was to compare the two kinds of treatment. Patients and methods:- This study was conducted in National center of Hematology, on 70 patients with erythrocytosis. Most of the patients were male, 54 males with 16 females, with male to female ratio of 3.3:1. 70 patients with erythrocytosis with hematocrit (Hct) equal to or above 50%in males and equal to or above 48% in females, the patients were divided to three groups for comparison: Group (1):24 patients were treated with phlebotomy. Group (2):24 patients were treated with therapeutic erythrocytaphyresis (TEA) only. Group (3): 22 Patients were treated with phlebotomy then switched to erythrocytapheresis (TEA). Applying (TEA), by discontinuous flow cell separator machine, MCS+(Haemonetics). The time interval between two successive treatments in each patient was recorded for all patients in the three groups of therapy. Results:- 79.15% of group-1 patients treated with phlebotomy required a short time: 2 weeks-2 months for the next phlebotomy, while only 5/24 (20.83%) of patients required longer time interval 3-4 months .In group-2 treated exclusively with TEA the majority 21 out of 24 patients (87.5%) had prolonged time interval for the next session of therapy from 3-7 months, with P value <0.002. Patients of Group-3 after switching to the new modality of therapy TEA, the time interval in the majority of patients had prolonged time interval for the next therapy from 3-7 months, 19 out of 22 patients (86.36%), with P value <0.002. No serious side effects noticed in patients treated with both types of treatments. TEA is more expensive, with longer working time. Conclusion:- Erythrocytapheresis (TEA) is more efficient than traditional phlebotomy with prolongation of the treatment interval in treating patients with erythrocytosis. Well tolerated by the patients, but it is more expensive, with relatively more technician working time.