Treatment of Essential Thrombocythemia in Patients Aged Over 60 with JAK2 Wild-Type and No History of Thrombosis

Clinical Scenario

This protocol covers essential thrombocythemia in the intermediate-risk category: patients aged over 60 years who are JAK2 wild-type, with no prior thrombotic events and no cardiovascular risk factors.

Age >60 years JAK2 wild-type No thrombosis history No cardiovascular risk factors

Clinical Goal

The primary aim in this setting is alleviation of vasomotor (microvascular) disturbances associated with essential thrombocythemia.

Treatment Approach

Low-dose aspirin is the treatment of choice in this intermediate-risk group.

The complete regimen — including scheduling, individualisation criteria, and full prescribing details — is available in the structured protocol.

Instant Access to Structured Evidence-Based Regimens

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).

Twice-daily aspirin is also our current treatment choice for intermediate-risk disease, but combination of a cytoreductive drug with once-daily aspirin is a reasonable alternative in intermediate-risk patients with CV risk factors (Figure 5).

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

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