Introduction

Polycythemia vera is a chronic myeloproliferative neoplasm, i.e. the production of blood cells is increased. Most prominently the erythrocytes, or red blood cells (RBCs) are affected which causes the main problems for the patients: If the ratio of erythrocytes to the whole blood volume, which in medical terms is called hematocrit, exceeds a certain threshold, the blood cells may clot and thus can cause thromboembolic events. This can lead e.g. to a stroke, heart attack or pulmonary embolism. Therefore if untreated, the mean life expactancy of patients suffering from PV is only about 18 month.

The basic therapy of PV is blood-letting (phlebotomy) of about 500 ml blood on a regular basis. As the body is compensating the bloodloss through plasma nearly instantly but needs several weeks to produce new red blood cells, the hematocrit can temporarily be reduced using this treatment. In severe cases this procedure is not sufficient and there is also the need to use chemotherapy (or a combination of both). Until now it is not known, how to compute the frequencies and volumes of the phlebotomies to give an optimal outcome for the patient.

This project tries to give an answer to this open question using mathematical modeling, numerical simulation, parameter estimation and optimization.