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Essential Thrombocythemia and Secondary Thrombocytosis

Pathophysiology/etiology

Thrombocytosis in adults: analysis of 777 patients.

Santhosh-Kumar CR, Yohannan MD, Higgy KE, al- Mashhadani SA.
J Intern Med. 1991;229:493-495.
Description: Prospective case-series of 777 patients with thrombocytosis. Provides prospective data on the most frequent causes of thrombocytosis.
PubMed citation number: 2045755

Evidence that essential thrombocythemia is a clonal disorder with origin in a multipotent stem cell.

Fialkow PJ, Faguet GB, Jacobson RJ, et al.
Blood. 1981;58:916-919.
Description: This paper exploited the X-linked G6PD locus in female patients with essential thrombocythemia to demonstrate the clonal nature of the disorder.
PubMed citation number: 7296002


Diagnosis

Experience of the Polycythemia Vera Study Group with essential thrombocythemia: a final report on diagnostic criteria, survival, and leukemic transition by treatment.

Murphy S, Peterson P, Iland H, Laszlo J.
Semin Hematol. 1997;34:29-39.
Description: A review of the original and updated diagnostic criteria for ET.
PubMed citation number: 9025160


Treatment

Hydroxyurea for patients with essential thrombocythemia and a high risk of thrombosis.

Cortelazzo S, Finazzi G, Ruggeri M, et al.
New Engl J Med. 1995;332:1132-1136.
Description: RCT of hydroxyurea versus no hydroxurea to maintain platelet count of less than 600,000/mm 3 in high-risk patients with ET. Hydroxyurea significantly decreased the incidence of thromboembolic complications.
PubMed citation number: 7700286

Interferon-alpha in the treatment of essential thrombocythaemia.

Lengfelder E, Griesshammer M, Hehlmann R.
Leuk Lymphoma. 1996;22:135-142.
Description: Review of the published literature on IFN and ET.
PubMed citation number: 8951784

No treatment for low-risk thrombocythaemia: results from a prospective study.

Ruggeri M, Finazzi G, Tosetto A, et al.
Br J Haematol. 1998;103:772-777.
Description: Prospective cohort study of low-risk patients with essential thrombocythemia (ET) treated expectantly. Demonstrated that in this population conservative management is a safe strategy.
PubMed citation number: 9858229

Second malignancies in patients with essential thrombocythaemia treated with busulphan and hydroxyurea: long-term follow-up of a randomized clinical trial.

Finazzi G, Ruggeri M, Rodeghiero F, et al.
Br J Haematol. 2000;110:577-583.
Description: Long-term follow-up of the RCT with hydroxyurea. At a median follow-up of 73 months, hydroxyurea versus control continued to very significantly decrease the risk of a thromboembolic event. However, 3.9% of the patients treated with hydroxyurea alone and 33% of patients treated with busulfan followed by hydroxyurea developed neoplasia. None of the patients who never received chemotherapy developed neoplasia.
PubMed citation number: 10997967

Long-term use of anagrelide in young patients with essential thrombocythemia.

Storen EC, Tefferi A.
Blood. 2001;97:863-866.
Description: A retrospective case series of 35 young patients with ET treated with anagrelide for 11 years. With anagrelide, patients had excellent control of the platelet count (sustained normalization in 54% of patients). Twenty percent of the patients had thrombotic complications, and 20% had hemorrhagic complications. Complications tended to occur at a platelet count of more than 400. Progressive anemia was noted with anagrelide.
PubMed citation number: 11159509

A single institutional experience with 43 pregnancies in essential thrombocythemia.

Wright CA , Tefferi A.
Eur J Haematol. 2001;66:152-159.
Description: A case series that reports that one-third of pregnancies in patients with ET end in spontaneous abortion, and that this incidence is not decreased by treating the ET.
PubMed citation number: 11350483


Review

Essential thrombocythemia.

Harrison CN, Green AR.
Hematol Oncol Clin N Am. 2003;17:1175-1190.
Description: Review of the pathobiology, clinical presentation, diagnosis, and management of ET.
PubMed citation number: 14560781

Thrombocytosis.

Schafer, AI.
New Engl J Med. 2004;350:1211-1219.
Description: Concise review paper of the approach to an elevated platelet count and the management of ET.
PubMed citation number: 15028825


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