Treatment of Essential Thrombocythemia

The aim of treatment, as with all diseases, is to reduce morbidity and mortality. Symptoms are present in 30 to 50 percent of patients at diagnosis. An increased incidence of thrombosis in small and (less often) in large vessels and of hemorrhage is well established in ET, particularly in older patients, who form the majority. There is also a small but definite risk of transformation to myelofibrosis and to acute leukemia. Whether transformation is influenced by treatment has not been established by prospective studies. Myelosuppressive (cytoreductive) treatment does decrease the thrombotic risk in older patients and in younger patients who have already experienced a thrombotic event (see below). It has been difficult to establish any improvement in survival, which anyway only becomes somewhat curtailed after many years. The existence of a group of younger patients with ET, (mentioned above), possibly having a rather different natural history and disease process, has been a focus of recent attention. There is particular anxiety about the potential risks of the prolonged use of cytoreductive agents if they were used routinely in this age group. No treatment that eradicates the abnormal clone is currently available.

How To Win Your War Against Anxiety Disorders

How To Win Your War Against Anxiety Disorders

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