How Essential Thrombocythemia and Polycythemia Vera Affect Blood Flow

Excess blood cell production in two myeloproliferative neoplasms (MPNs) — essential thrombocythemia, or ET, and polycythemia vera, also known as PV — can impair circulation, according to Dr. Tiziano Barbui.

Barbui is a professor of hematology and founder of the department of hematology at Bergamo Hospital. He is currently the scientific director of clinical research foundation at Papa Giovanni XXIII Hospital, Bergamo, Italy.

In a video interview with CURE, Barbui explained that both diseases begin in the bone marrow and are marked by abnormal increases in blood cell counts. In polycythemia vera, red blood cells are overproduced, increasing blood viscosity and making it harder for blood to flow through small vessels. In essential thrombocythemia, the problem lies with excess platelet production.

Barbui emphasized that treatment is essential not only to relieve symptoms but also to prevent more serious complications linked to impaired blood circulation in both MPNs.

Transcript:

These two diseases, called essential thrombocythemia and polycythemia vera, are chronic hematologic conditions. Like other tumors, they originate in the bone marrow and cause abnormal overproduction of blood cells. In PV, this overproduction specifically affects erythrocytes (red blood cells), while in ET, the excess production involves platelets.

Both diseases are defined by an overproduction of blood cells in the bone marrow. This increased cell volume can make blood circulation, especially in the small vessels, more difficult. In the case of polycythemia vera, the high number of red blood cells leads to increased blood viscosity, making it harder for blood to flow. As a result, circulation may become obstructed in some blood vessels.

This is why patients with an excess of red blood cells often undergo phlebotomy — to reduce the number of circulating cells and improve blood flow. Without this intervention, blood flow may be impeded or stop altogether. However, the problem isn’t limited to the excess number of blood cells alone.

Transcript has been edited for clarity and conciseness.

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