Whole blood phlebotomy is the treatment for patients with iron overload due to HH. Therapeutic phlebotomy for HH is generally well-tolerated, low-cost, and effective in reducing iron levels.
Each unit of blood contains approximately 200 to 250 mg of iron. As erythrocytes are removed by phlebotomy, iron stores are mobilized and utilized to produce new, circulating erythrocytes. Stored iron is removed through periodic phlebotomies until iron-deficient erythropoiesis is induced.
The initial, or iron reduction, phase of treatment typically consists of removing one unit (450 mL) of whole blood once or twice weekly. The patient's hemoglobin and hematocrit must be checked before phlebotomy to ensure that the patient is not anemic. A sample of serum ferritin is also collected at this time.
