Essential thrombocythemia treatment algorithm 2018

Area of Science:

• Hematology
• Oncology
• Internal Medicine

Background:

• Myeloproliferative neoplasms, essential thrombocythemia (ET) and polycythemia vera (PV), lack curative therapies.
• Current treatments for ET and PV do not demonstrably prolong survival.
• Prognosis for ET and PV is generally favorable, with long median survivals.

Purpose of the Study:

• To present a risk-adapted, point-of-care treatment algorithm for ET and PV.
• To emphasize a "less is more" approach, avoiding unproven novel therapies.
• To guide treatment decisions based on evidence and extensive clinical experience.

Main Methods:

• Identification of three major thrombosis risk factors: history of thrombosis, JAK2/MPL mutations, and advanced age.
• Categorization of ET patients into four risk groups: very low, low, intermediate, and high risk.
• Development of a treatment algorithm based on these risk categories.

Main Results:

• The algorithm stratifies patients based on combined risk factors.
• It guides the selection of appropriate therapies to prevent thrombosis.
• It advocates for established treatments over newer, unproven drugs.

Conclusions:

• A risk-adapted approach is crucial for managing ET and PV.
• Established therapies are effective for thrombosis prevention in ET and PV.
• The algorithm provides a practical tool for clinicians managing these conditions.