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Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The polycythaemia caused by COPD may be corrected by venesection. This treatment modality is now only rarely used.

Phlebotomy for secondary polycythaemia (SP) due to hypoxia can be considered in patients with symptomatic hyperviscosity or hematocrit greater than 56% (1)

  • the British Journal of Haematology endorses a Grade B recommendation to reduce hematocrit to 50-52% in selected patients with SP due to hypoxic pulmonary disease, but there is concern that reducing the red cell mass may theoretically worsen tissue hypoxia


  • Fuqua J, Reece J, Sofka S. Successful use of phlebotomy to treat severe secondary polycythemia due to chronic lung disease. Hematol Rep. 2021 Jun 9;13(2):8961.

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