MPN

How do you risk stratify high and intermediate risk essential thrombocytosis patients versus low- and very- low risk patients with respect to hydroxyurea and anti-coagulant/aspirin use?
High and intermediate risk
Presence of venous thromboembolism – hydroxyurea and Coumadin
Presence of arterial thromboembolism – hydroxyurea and aspirin
Age greater than 60 and no thrombosis history – hydroxyurea and aspirin

Low and very low risk
Presence of vasomotor symptoms – aspirin
JAK2 mutation and cardiac disease risk factors – aspirin twice a day
JAK2 mutation or cardiac risk factors aspirin – once a day
JAK2 negative and no cardiac risk factors – observation only

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