Essential thrombocytosis (primary thrombocythemia) is a myeloproliferative disorder associated with an increase in number and size of circulating platelets.
Half of all patients are asymptomatic, but clinical presentations include thrombosis and bleeding. There are no pathognomonic features and it is a diagnosis of exclusion.
Four risk categories exist to group patients with essential thrombocytosis: very low-risk, low-risk, intermediate-risk, and high-risk.
Treatment approach should be individualized and may include lifestyle modification and observation, cytoreductive therapy, antiplatelet and anticoagulant therapy.
Hydroxyurea is the preferred cytoreductive agent in most people with the disease. Interferon, busulfan, and anagrelide are alternative treatments.
The life expectancy for people with essential thrombocytosis is usually similar to that for people without the disease. Patients need CBCs on a regular follow-up basis.
Essential thrombocytosis is also known as primary thrombocythemia. It is a chronic myeloproliferative disorder associated with sustained dysregulated megakaryocyte proliferation, increasing the number of circulating platelets. It is associated with thrombosis and bleeding.
History and exam
- bone marrow biopsy and histopathology
- Janus kinase 2 (JAK2) mutation testing of peripheral blood
- myeloproliferative leukemia virus oncogene (MPL) mutation testing of peripheral blood
- calreticulin (CALR) mutation testing of peripheral blood
- BCR-ABL fluorescent in situ hybridization (FISH) of bone marrow
Debabrata Mukherjee, MD, FACC
Chairman, Department of Internal Medicine
Chief, Cardiovascular Medicine
Professor of Internal Medicine
Texas Tech University Health Sciences Center at El Paso
DM declares that he has no competing interests.
Tony Kan, MD
Senior Staff Physician
Henry Ford Medical Center
TK declares that he has no competing interests.
Uri Rozovski, MD
Department of Cardiology
Tel Aviv Sourasky Medical Center
UR declares that he has no competing interests.
David A. Garcia, MD
Division of Hematology
University of Washington Seattle
DAG declares that he has no competing interests.
Bethany Samuelson, MD
Division of Hematology
University of Washington
BS declares that she has no competing interests.
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