Post-transplant erythrocytosis (PTE) is a recognised cause of secondary polycythemia that emerges in a subset of patients following haematopoietic stem cell transplantation (HSCT). Identifying and managing the resulting elevated haematocrit is central to care in this setting.

Clinical Scenario

PTE occurs in approximately 1% of patients after haematopoietic stem cell transplantation. Onset tends to begin around 11 months post-transplant, and the condition can be self-limiting, lasting approximately 6 months. Even in self-limiting cases, haematocrit must be monitored and managed while it remains above target.

Treatment Approach

Management in this post-HSCT setting centres on a specific blood-volume reduction procedure, applied on an ongoing basis. The structured protocol defines the precise indications, monitoring schedule, and clinical decision points — none of which should be applied without the complete regimen. The full protocol — including the complete management algorithm and monitoring parameters — is available via the link below.

References

DOI: 10.1111/bjh.15647

PTE also occurs in approximately 1% of patients after haematopoetic stem cell transplantation (HSCT) and after combined pancreatic–renal transplant, with a reported incidence of 16%.
PTE after HSCT starts, on average, about 11 months after the transplant and can be self-limiting, lasting approximately 6 months.
Consider venesection in post-haematopoetic stem cell transplantation, aim for a Hct <0.50.
All were treated with venesection on an ongoing basis.

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What Is the Treatment of Secondary Polycythemia in Post-Transplant Erythrocytosis After Haematopoietic Stem Cell Transplantation?

References