Table 3. Effect of 32 P therapy or... | American Society of Hematology

Table 3.

Effect of ³²P therapy or phlebotomy on the plasma volume and systemic vascular resistance in polycythemia vera

Measurement	Therapy
	³²P		Phlebotomy
	Before	After	Before	After
Systemic vascular resistance, dynes s cm⁻⁵	1421	1990^3-150	1504	1464
Red cell mass, mL/kg	57.3	28.4^3-150	54.8	39.5^3-150
Plasma volume, mL/kg	37.0	39.3	38.5	48.7^3-150
Total blood volume, mL/kg	94.3	67.6^3-150	93.3	88.2^3-150
Hematocrit, %	64.0	44.0^3-150	63.0	47.0^3-150
Hemoglobin, gm%	19.9	14.9^3-150	19.9	14.9^3-150

Measurement	Therapy
	³²P		Phlebotomy
	Before	After	Before	After
Systemic vascular resistance, dynes s cm⁻⁵	1421	1990^3-150	1504	1464
Red cell mass, mL/kg	57.3	28.4^3-150	54.8	39.5^3-150
Plasma volume, mL/kg	37.0	39.3	38.5	48.7^3-150
Total blood volume, mL/kg	94.3	67.6^3-150	93.3	88.2^3-150
Hematocrit, %	64.0	44.0^3-150	63.0	47.0^3-150
Hemoglobin, gm%	19.9	14.9^3-150	19.9	14.9^3-150

In contrast to phlebotomy therapy, ³²P not only reduced the red cell mass but also the plasma volume, resulting in an increase in systemic vascular resistance even though the red cell mass was reduced to normal. Elevation of the plasma volume by phlebotomy expanded the total blood volume and reduced systemic vascular resistance even though phlebotomy therapy in these patients was insufficient to reduce the red cell mass to normal. Noteworthy for the phlebotomy group is that the hematocrit and hemoglobin levels were apparently normal even though the red cell mass was still increased due to masking by the expanded plasma volume. The data are from Segel and Bishop.297

F3-150

Significantly different from before therapy (P < .01).

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