علاج كثرة الصفيحات الدموية الأساسية مع طفرة JAK2 في المرضى الذين تبلغ أعمارهم ≤60 عامًا دون تاريخ من الجلطات

References

DOI: 10.1002/ajh.27216

Figure 5 outlines our general treatment approach in ET, which starts with thrombosis risk stratification: very low (age ≤60 years, no thrombosis history, JAK2 wild-type), low (same as very low but JAK2 mutation present), intermediate (age >60 years, no thrombosis history, JAK2 wild-type), and high (thrombosis history present or age >60 years with JAK2 mutation).

Once- or twice-daily aspirin is strongly advised in low-risk patients, in the absence or presence of CV risk factors, respectively (Figure 5).

On the contrary, we recommend the use of low-dose aspirin (81 mg/day; range 40–100 mg/day) in all patients with low-risk JAK2-mutated ET, provided there are no major contraindications; the latter include clinically significant VWF:RCo <20% associated with bleeding complications.

Low-dose aspirin therapy has also been shown to be effective in alleviating vasomotor (microvascular) disturbances associated with ET or PV.