Treatment indications and choice of a platelet-lowering agent in essential thrombocythemia.

摘要: The therapeutic strategy in patients with essential thrombocythemia (ET) is a difficult balance between the prevention of bleeding and thrombotic complications risks drug side effects toxicity. Major rare seems to be related higher platelet counts. Therefore, count greater than 1500 x 10(9)/L generally regarded as an indication for cytoreduction. Thrombotic include microvascular occlusive symptoms, which are usually reversible low-dose aspirin, large vessel thrombosis. risk major thrombosis ET who older 60 years have had previous event. In this high-risk group, nonalkylating agent hydroxyurea significantly reduces rate vascular has emerged treatment choice. However, long-term risk:benefit ratio remains disputed because its leukemogenic potential not been ruled out. This holds also other myelosuppressive agents such busulfan pipobroman. Other drugs particular interest young recombinant interferon-alpha anagrelide. Both these effective lowering counts, but their efficacy reducing clinical demonstrated. Furthermore, interferon anagrelide frequent clinically important effects. Thus, further studies required establish role management ET.