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[Essential thrombocythemia--clinical course from personal material]
M Bieniaszewska1, A Hellmann, J Kabata
1Kliniki Hematologii I.Ch.W., Akademii Medycznej w Gdańsku.
The article presents clinical course analysis of essential thrombocythemia in 17 patients aged 29-82. The diagnostic criteria were the same as described by Polycythemia Vera Study Group. Mean platelet level of diagnosis was 1680 x 10(9)/l. Haemorrhagic complications were observed in 42% of the patients, while thrombotic ones or embolisms in 35%. In two cases both types of complications occurred. Asymptomatic course of the disease was observed in 5 patients. The statistical analysis proved that the patients with platelet count between 900-1900 x 10(9)/l are in danger of developing thrombotic episodes and thus antiaggregation treatment should be considered. If platelet level exceeds 1900 x 10(9)/l the risk of haemorrhage increases, so antiaggregation treatment is contraindicated and thrombocytapheresis is advised instead. The patients was started on treatment when platelet count was above 1000 x 10(9)/l in asymptomatic cases or with lower platelet level in symptomatic ones. The treatment consisted of busulphan, hydroxyurea or interferon alpha (in one of the patients) until lowering platelet level below 600 x 10(9)/l.
The article presents clinical course analysis of essential thrombocythemia in 17 patients aged 29-82. The diagnostic criteria were the same as described by Polycythemia Vera Study Group. Mean platelet level of diagnosis was 1680 x 10(9)/l. Haemorrhagic complications were observed in 42% of the patients, while thrombotic ones or embolisms in 35%. In two cases both types of complications occurred. Asymptomatic course of the disease was observed in 5 patients. The statistical analysis proved that the patients with platelet count between 900-1900 x 10(9)/l are in danger of developing thrombotic episodes and thus antiaggregation treatment should be considered. If platelet level exceeds 1900 x 10(9)/l the risk of haemorrhage increases, so antiaggregation treatment is contraindicated and thrombocytapheresis is advised instead. The patients was started on treatment when platelet count was above 1000 x 10(9)/l in asymptomatic cases or with lower platelet level in symptomatic ones. The treatment consisted of busulphan, hydroxyurea or interferon alpha (in one of the patients) until lowering platelet level below 600 x 10(9)/l.