Our experience and review of the literature suggests that thromboembolism is a major cause of morbidity and death in polycythemia vera patients. Using methods developed by our group (Ambrus et al, Angiology 34 418–426, 1984) we determined membrane fluidity, deformability of red cell membranes. We found that compared to normal controls, red cell membranes in polycythemia vera patients were relatively stiff and the red cells less deformable when passed through microtubules. These abnormal red cell membranes also caused platelet aggregation. In the circulation of polycythemia vera patients we also found increased platelet aggregates using the detection method of

Wu et al (Wu et. al, Lancet 2: 924–926 1974
,
Wu et. al, Thromb. Res. 7:917–924, 1975
). Other factors in the thromboembolic complications included

  1. increased hematocrit

  2. hyperviscosity syndrome

  3. increased thromboxane A2 content of platelets

  4. increased tendency to disseminated intravascular coagulation (DIC) (factors involved were also investigated).

Red cell membrane fluidity and platelet aggregation may be points of therapeutic attention to prevent thromboembolic complications. Suggestions of approaches to this problem by future research will be discussed.

Topics:
polycythemia vera, thromboembolism, disseminated intravascular coagulation, hyperviscosity syndrome, thrombocytosis, thromboxane, platelet aggregation, hematocrit, erythrocytes, tissue membrane

Disclosure: No relevant conflicts of interest to declare.

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2006, The American Society of Hematology
2006
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