Dear Dr. Roach: Im an 88-year-old woman whose platelets went into the 500,000 range. I was sent to a hematologist/oncologist, who said it was a bone marrow disease. I was put on hydroxyurea 500 mg. A couple of months later, a blood test showed enlarged red blood cells, which I understand is from the hydroxyurea, but my doctor says it also prevents blood clots and strokes. However, in July I got a blood clot in my leg, and I am now on Xarelto for life. My question is if you think I could get additional clots from hydroxyurea, and if this is the best treatment. G.R.
Answer: You have a condition called essential thrombocythemia. Essential means we dont know what causes it; while thrombo- is for clot; cyt is for cell; and hemia is for the blood, so its too many clotting cells (platelets) in the blood. It is now known that ET is almost always related to a genetic mutation, especially one called JAK2.
Some people get diagnosed because of symptoms such as headaches, or due to complications, especially clotting or bleeding. However, many are diagnosed just because their routine blood test shows a high platelet level. The goals of treatment are to relieve symptoms, if any, and to prevent complications.
