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Essential thrombocythaemia (ET)

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Essential thrombocythaemia (ET) treatment and side effects

In this section we talk about the specific treatments used for essential thrombocythaemia (ET).You might also want to read our general information about how blood cancer treatment is planned and managing your treatment.

We also have some important information on staying safe if you’ve got blood cancer, covering things like risk of infection and vaccinations.

The treatment you receive for ET depends in part on your risk of developing complications. People with ET are generally divided into low, intermediate or high-risk categories. This is based on a combination of the following factors:

  • your age,
  • the symptoms you have,
  • your medical history (including risk factors for blood clots), and
  • your platelet count.

You should be monitored for cardiovascular risk factors such as diabetes, high cholesterol, high blood pressure and smoking, as these should be addressed as effectively as possible.

There are a number of treatment options for ET:

If you have a low risk of complications, you may be treated with aspirin.

Aspirin can help prevent thrombosis (blood clots) because it affects the way platelets stick together. This doesn’t affect your platelet count, but helps to reduce the risk of blood clots. If you need to take painkillers for any other reason, ask your doctor which ones are safe.

You may have mild chemotherapy to treat your ET. Whether you have chemotherapy depends on a number of things, including:

  • your risk of thrombosis,
  • how well you’ll be able to cope with the side effects, and
  • your personal preference.

If your doctor thinks you need mild chemotherapy, you may be prescribed a tablet called hydroxycarbamide (or hydroxyurea). This is a mild form of chemotherapy and works by reducing the number of platelets in your blood. Hydroxycarbamide is the most common chemotherapy drug used to treat ET. It does have some side effects: you may get diarrhoea, constipation or get more infections than usual.

Hydroxycarbamide is a very safe treatment. However, there’s a theoretical risk that it may increase the risk of ET transforming into acute myeloid leukaemia (AML) if it’s used as a long term treatment. For many people, the benefits of this treatment usually outweigh any potential small risk.

Busulfan is another mild chemotherapy drug. It may be used when hydroxycarbamide isn’t appropriate or isn’t working. It’s given as a tablet. Side-effects can include lung tissue damage or reduced numbers of red blood cells, white blood cells or platelets in the blood. Busulfan can also increase the risk of leukaemia developing, so it’s only used when doctors believe the benefits of treatment outweigh the risks.

Interferon is an injection that slows down the production of platelets. It’s not thought to carry the same risk as hydrodroxycarbamide so is the preferred choice in younger patients. However, many patients find the short-term side effects unpleasant and not all patients can tolerate interferon therapy.

Possible side effects you may get while being treated with interferon include:

  • flu-like symptoms,
  • headaches,
  • dizziness,
  • mood swings, and
  • tirednes.

Anagrelide is usually given only when other treatments have already been tried. It’s taken as a capsule but may increase the risk of developing myelofibrosis.

Treatment during the coronavirus pandemic

While the coronavirus pandemic continues, your healthcare team will do their best to protect you. This might mean changes to how you're treated or where you're treated. Speak to your healthcare team if you have any questions about your treatment options.

Read our information about coronavirus and your blood cancer treatment.

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