Interventions

Primary polycythemia

Reduce blood viscosity

• Periodic phlebotomies (removing approximately 350-500 mL of blood) to help the patient maintain normal hemoglobin and hematocrit levels, usually repeated every other day

• Bone marrow suppression with radioactive phosphorus (32P) or chemotherapy (melphalan, busulfan, and chlorambucil) can usually control the disease process (medications can cause leukemia and therefore only used in most seriously ill or elderly patients).

• Pheresis techniques are used to remove red blood cells (RBCs), white blood cells (WBCs), and platelets and to return plasma to blood.

Secondary polycythemia

Treat disease that acts

• Change of location for those who live at high

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