Hello to everyone.
TE guidelines (Tefferi 2019) don't mention any critical level of Hct for phlebotomy, not even in patients with Jak2 mutation. (stratified as high risk for thrombotic complications).
My usual approach is:
- without others risk factors for thrombosis - Target HCT < 50%
- with risk factors for thrombosis or previous thrombosis - Target HCT < 45
Can I have an opinions/suggestions by someone?
Thank you
Hi Ivo,
https://ashpublications.org/blood/article/128/20/2403/35610/How-I-treat-essential-thrombocythemia:
For JAK2+ ET that transforms to PV, a phlebotomy program is implemented aimed at maintaining Hct
Hi Ivo,
Sorry for my delayed answer. I am sure you found answer for your question.
Generally, if we see a patient with isolated ET without signs of PV, hematologists do not perform phlebotomy on the routine basis. There are 2 articles (probabaly you have them already) where there are not hematocrit among hematologic values in the management of ET (J.C. Hernandez-Boluda & M.Gomez, 2014). I couldn't find phlebotomy in the first, the second-line therapy route in the famous review by A.Tefferi & A.Pardanani, 2019. Sorry for possible misunderstanding of your question. Good luck!
HI
Why will not treat them as a PV patient? with the same HTO level target?
Phebotomy or iron? Iron deficit secondary to phlebotomy could promote higher platelet level. This is the question
We need RCT.
Great question IVO
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