DETERMINING THE RISK OF THROMBOSIS AMONG THE PATIENTS WITH ESSENTIAL THROMBOCYTHEMIA

The aim of the studywas to determine the risk of thrombosis among patients with Essential thrombocythemia based on the modern criteria of diagnosis and to reveal the treatment accordingmethods of research in Georgia. We analyzed clinical manifestations of 25 cases of Essential thrombocythemia diagnosed in 2013-2017 y. at the Institute of Hematology and Transfusiology. Among 25 patients, female was 20 (80%), male - 5 (20%). Age varies from 28 to 75 years. Patients had the following clinical manifestations: The severity of the lower limbs, numbness, pain (erythromelalgia) in 13 (52%) of cases, headache in 7 (28%), dizziness in 5 (20%), splenomegaly in 6 (24%), bleeding in 1 (4%), several discontinued pregnancy in the first trimester in 1 (4%), thrombotic complication had been diagnosed in 8 (32%) of patients. In 8 (32%) patients with thrombosis in medical history, myocardial infarction had 2 patient, ischemic stroke - 2 patient, deep vein thrombosis - 2 patient, thrombosis of spleen artery - 1 patient, door vein thrombosis -1 patients. Laboratory indicators for patients at the moment of diagnosis were as follows: Hemoglobin level was 120-160g/L, Erythrocytes-3,7-5,2x1012/L, Leukocytes-10,2-35,5x109/L, Platelets - 860,0-4300,05x109/L. Cytological study ofbone marrow revealed hyper cellular bone marrowwith neutrophilic profile. There are a large number of megakaryocites and their large clusters. In bone marrow biopsy bone and bone marrow structure is mainly stored. There is a hyperplasia of myeloid tissue, a sharp or moderate hyperplasia of megakaryocite. Sometimes weak fibrosis is expresseds (4 patients). JAK-2 genes can only be studied in 3 (12%) cases: in 2 (8%) cases, gene mutations were 48% and 52%, while the gene mutation with 1 (4%) patient was only 12%. Based on international multi-center studies by WHO experts group, the risk of thrombosis development was predictable (WHO-ET-IPSET-thrombosis). Based on our data, we have identified thrombotic risk groups as well as the criteria that contributed to the increased risk: these are more likely to have thrombotic complications in medical history, existence ofJAK-2gene mutation, lesser than age >60years, risk factors from the cardiovascular system (Diabetes mellitus,Hypertension, smoking). From the patients who were studied, 10 (40%) were in the high risk group of thrombosis, 3 (12%) in the average risk group and 12 (48%) in thelow risk group. The goal of treatment of Essential thrombocythemia is to stop the progression of the disease and cure the symptoms of the disease.The methods of treatment for improving the quality of life of patients are multi-component and are divided into the following groups: 1) Prophylaxis of thrombotic complications; 2) cytoreductionalchemothrapy; 3) targeted therapy- JAK-2kinase activity inhibitors; 4) treatment of complications.