Should Patients Be Treated for Low-Risk Essential Thrombocythemia?

Whether asymptomatic patients with essential thrombocythemia (ET) require treatment is controversial. When patients' platelet counts exceed the normal range, many clinicians will initiate antiplatelet (aspirin, dipyridamole) therapy, but this might not prevent thromboses and could promote bleeding.

To assess the safety and effectiveness of antiplatelet therapy for patients with asymptomatic ET, investigators in Spain performed a hospital-based, retrospective study of 300 patients with low-risk ET, defined as those <60 with no history of previous vascular events. Two thirds of patients received antiplatelet therapy, and one third were observed. At the time of diagnosis, age, sex, platelet and white blood cell counts were comparable in the two…