Management of secondary thrombocytosis

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

What is your management of secondary thrombocytosis?

Chris Hillis, MD, MSc: The most common cause of secondary thrombocytosis is iron deficiency. Certainly, the burden of iron deficiency is quite high worldwide and the obvious treatment there would be to replace the iron. Then we will see that the platelet count will decrease. In other instances there is no good evidence to guide what to do in those situations.

As the platelet count does rise above 1 million or 1.5 million, I will still check the von Willebrand [factor] levels in these patients to ensure they are not developing acquired von Willebrand syndrome. I have yet to find one because the mechanism is more than just the platelet count, although that certainly does play a big role in it. Then it oftentimes becomes looking for the cause and then trying to eliminate it.