Polycythemia vera (PV) is a chronic myeloproliferative neoplasm characterized by increased red blood cell mass. Excess erythrocytosis leads to elevated hematocrit, resulting in increased blood viscosity, a condition that promotes thrombosis. For years, red blood cells (RBCs) in PV were considered to be morphologically and functionally normal. This analysis aimed to check whether there are biochemical alterations in RBCs in PV that may be associated with thrombotic complications.

We included 5 patients with PV and 5 healthy individuals in the preliminary analysis of the biochemical properties of isolated RBCs focused on different forms of hemoglobin and heme. The analysis was conducted using Raman spectroscopy.

The results of the Raman spectra obtained from isolated RBCs suggest a larger contribution of ferrous heme iron in the sample of a patient with PV compared to a control sample. In the PV sample, a greater contribution of the high-spin heme iron, a molecular state typical for deoxyhemoglobin, was observed, which stays in line with higher ferrous content. The effect may indicate a weaker linkage of the protein with oxygen.

Our analysis suggests the occurrence of biochemical alterations in RBCs in PV, together with RBC overproduction. Changes in the structure of hem and hemoglobin affect oxygen affinity. Our future study will focus on determining if described alterations in RBCs may contribute to the pathogenesis of thrombotic complications in PV.