Antiplatelet treatment in patients with ET or PV

Dr Chris Hillis is an assistant professor in the Division of Oncology at McMaster University and hematologist at the Juravinski Hospital and Cancer Centre.

Are there any patients with essential thrombocythemia (ET) or polycythemia vera (PV) who do not need antiplatelet treatment?

Chris Hillis, MD, MSc: All patients with PV should be considered for antiplatelet therapy. We have randomized control trial evidence demonstrating the benefit of this. If a patient is on an anticoagulant at therapeutic doses and has PV, you can likely stop the antiplatelet agent, unless there is a compelling reason for them to be on both an anticoagulant and an antiplatelet.

For ET, we are beginning to understand that there is a population of patients who do not require antiplatelet therapy. Those are the ones who are at the very low risk on the International Prognostic Score for Thrombosis in Essential Thrombocythemia (IPSET), which means they have no cardiovascular risk factors and are of a young age and JAK2-negative.