What is the treatment for essential thrombocythemia?

Question

Hi doctor,

My father had an elevated platelet count for two months, around 21 to 35 lakhs, suspected to be essential thrombocythemia. When checked with the doctor, JAK2, NPN panel, and bone marrow biopsy tests are negative. They have been given Hydroxyurea and Ecosprin tablets. Already, my dad was a stroke patient, affecting his speech and understanding level. After using those medicines, he had blood motions, then his blood level was 4.6 gm/dL, and his platelet was 6.8 lakhs. Then he stopped using those medicine, and after treatment, his blood level was raised to 8.7 gm/dL, and his platelets were 6.9 lakhs. After two weeks, we again went for the blood test, and now the platelet and hemoglobin levels are in normal values like hemoglobin 9.60 gm/dL, platelets 300,000 per microliter of blood.

Could you please help me understand the treatment he should undergo for the above situation? Does he have to continue Hydroxyurea and Ecopsirin?

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Your father was prescribed Ecosprin and Hydroxyurea due to a very high platelet count. Now the platelet count is within the limit. So, no need to continue Hydroxyurea. However, platelet count has to be monitored regularly.

Usually, such a high platelet count is due to an essential thrombocythemia-like cause. But JAK 2 ((janus kinase 2) mutation and bone marrow biopsy were negative as per history. So myeloproliferative neoplasm and essential thrombocythemia are not present.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.