Thrombocytosis: Treatment

The key to treating secondary thrombocytosis is treating the underlying condition.

Any patient who has thrombocytosis should be encouraged not to smoke.

In young people who have no symptoms, this condition can remain stable for many years. These patients should be monitored by a physician, but may not require treatment.

Treatment for patients who do have symptoms focuses on controlling bleeding, preventing the formation of blood clots, and lowering platelet levels. Treatment for secondary thrombocytosis involves treating the condition or disease responsible for excess platelet production.

In 1997, the United States Food and Drug Administration (FDA) approved the use of anagrelide HCl (Agrylin) to reduce elevated platelet counts and decrease the risk of clot formation. Some patients have benefited from the use of hydroxyurea, an anti-cancer drug.

Low doses of aspirin may prevent clotting, but can cause serious hemorrhages.

If drug therapy does not bring platelet counts down to an acceptable level as rapidly as necessary, platelet-pheresis may be performed. Usually combined with drug therapy and used primarily in medical emergencies, this procedure consists of:

• withdrawing blood from the patient's body
• removing platelets from the blood
• returning the platelet-depleted blood to the patient

— Maureen Haggerty