Essential thrombocythemia: Difference between revisions

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* Must distinguish from other myelodysplastic disorders (especially polycythemia vera) as well as from secondary causes of thrombocytosis
* Must distinguish from other myelodysplastic disorders (especially polycythemia vera) as well as from secondary causes of thrombocytosis


== Clinical Presentation ==
== Clinical Manifestations ==


* History
* History

Revision as of 17:07, 19 July 2020

Definition

  • Myelodysplastic disorder of the thrombocytopoeitic stem cells causing a clonal proliferation of thrombocytes

Differential Diagnosis

  • Must distinguish from other myelodysplastic disorders (especially polycythemia vera) as well as from secondary causes of thrombocytosis

Clinical Manifestations

  • History
    • History of thrombosis or bleeding
  • Signs & Symptoms
    • Digital ischemia
    • Cerebrovascular ischemia
  • High risk for vascular events if:
    • History of thrombosis or bleeding
    • Increased cardiovascular risk
    • Older than 60 years

Management

  • Acute
    • If digital or cerebrovascular ischemia, rapid cytoreduction with plateletpheresis
  • Chronic
    • If high risk, requires cytoreduction and aspirin:
      • First-line: hydroxyurea
      • Alternative: anagrelide
      • Pregnancy: interferon alfa
    • If >1.5m platelets, requires cytoreduction alone