II. Epidemiology
- More common in women
III. Symptoms and signs
- Common
- Less common
- Thrombotic events
- Bleeding events
IV. Differential Diagnosis
- Reactive Thrombocytosis
- Clonal Thrombocytosis
- Chronic myeloproliferative disorder
V. Labs (rule-out differential diagnosis above)
- C-Reactive Protein (CRP) Normal
- Erythrocyte Sedimentation Rate Normal
- Fibrinogen Level Normal
- Bone Marrow Biopsy Normal
VI. Management
- Age Under 60 years
- Low risk patients
- Consider low dose Aspirin
- Intermediate risk patients
- Platelet Count <1500 x10^3/uL
- Anagrelide
- Low dose Aspirin
- Platelet Count >1500 x10^3/uL
- Anagrelide
- Platelet Count <1500 x10^3/uL
- High risk patients
- Hydroxyurea
- Anagrelide
- Low dose Aspirin
- Low risk patients
- High risk patients over age 60 years
- Low dose Aspirin
- Hydroxyurea
- Women of child bearing age
- Consider low dose Aspirin
- Interferon alfa in high risk patients
VII. Complications (low Incidence)
VIII. Prognosis: Factors predictive of poor prognosis
- Age over 60 years
- Thrombosis history