Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2024 Jun;54(6):909-915.
doi: 10.1111/imj.16313. Epub 2023 Dec 25.

A comparison between erythrocytapheresis and venesection for the treatment of JAK2-mutated polycythaemia

Trung Q Ngo  1 , Matthew W Scott  2 , Shreerang Sirdesai  1 , Jennifer L Hempton  1 , Georgina S Hodges  1 , Philip J Campbell  1   2
Affiliations
Comparative Study

A comparison between erythrocytapheresis and venesection for the treatment of JAK2-mutated polycythaemia

Trung Q Ngo et al. Intern Med J. 2024 Jun.

Abstract

Background: JAK2-mutated polycythaemia vera (PV) is associated with reduced survival because of thrombotic events and haematological disease transformation. Therapeutic venesection has traditionally been used to lower haematocrit, but the technique of erythrocytapheresis has emerged over the last decade.

Aim: To compare erythrocytapheresis with venesection as treatment for PV by assessing medical efficacy and financial viability.

Methods: One hundred sixteen patients with PV who received red cell depletion therapy at Barwon Health between 2014 and 2021 were identified. The haematocrit drop after each session, interval between treatment times and number of sessions required to achieve a haematocrit <0.45 were compared with an independent t test. Thrombosis rates were compared with Pearson's chi-squared test. Cost-funding analysis was done by assessing the Weighted Inlier Equivalent Separation and National Weighted Activity Unit funding models.

Results: Patients treated with erythrocytapheresis achieved a greater haematocrit drop each treatment session (0.075 vs 0.03, P < 0.01), required fewer sessions to achieve a haematocrit <0.45 (1 vs 4, P < 0.01) and experienced fewer thrombotic complications (8.7% vs 32.1%, P = 0.02) than those treated with venesection. Cost-funding analysis demonstrated that erythrocytapheresis was more financially viable with a surplus of AU$297 per session compared to a deficit of AU$176 with venesection. Even if funding for venesection is increased, the cost of erythrocytapheresis may be mitigated by a lower number of procedures required per year (3.8 vs 5.3, P < 0.01).

Conclusions: Erythrocytapheresis is more efficacious than venesection for the treatment of PV and is accompanied by rapid reductions in haematocrit and reduced thrombotic complications.

Keywords: JAK2; erythrocytapheresis; polycythaemia; venesection.

PubMed Disclaimer

References

    1. Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood 2016; 127: 2391–2405.
    1. Tefferi A, Guglielmelli P, Larson DR, Finke C, Wassie EA, Pieri L et al. Long‐term survival and blast transformation in molecularly annotated essential thrombocythemia, polycythemia vera, and myelofibrosis. Blood 2014; 124: 2507–2513 quiz 615.
    1. Finazzi G, Barbui T. How I treat patients with polycythemia vera. Blood 2007; 109: 5104–5111.
    1. McMullin MFF, Mead AJ, Ali S, Cargo C, Chen F, Ewing J et al. A guideline for the management of specific situations in polycythaemia vera and secondary erythrocytosis. Br J Haematol 2019; 184: 161–175.
    1. Marchioli R, Finazzi G, Specchia G, Cacciola R, Cavazzina R, Cilloni D et al. Cardiovascular events and intensity of treatment in polycythemia vera. N Engl J Med 2013; 368: 22–33.

Publication types

LinkOut - more resources