كثرة الصفيحات الأولية مع تاريخ الجلطة الشريانية: العلاج من الخط التالي عندما لا يتحكم هيدروكسي يوريا في عدد الصفيحات

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).
• We also believe it is reasonable to use twice-daily aspirin in patients with arterial thrombosis if they are older or harbor JAK2 mutations or in the presence of CV risk factors (Figure 5).
• ET patients who are either intolerant or resistant to HU are effectively managed by IFN-α (pegylated preparations preferred) or busulfan.
• Among these 2 s-line drugs, we prefer the use of IFN-α for patients younger than age 65 years and busulfan in the older age group, although there is no controlled evidence to support or refute such a strategy.
• The dose of HU is titrated to keep platelet count in the normal range.