Dr. Spivak on Diagnosing Essential Thrombocythemia

Jerry L​e Pow Spivak, MD, professor of ​medicine and ​oncology, Johns Hopkins University School of Medicine, director, Center for the Chronic Myeloproliferative Disorders, ​Johns Hopkins Medicine, discusses diagnosing essential thrombocythemia (ET).

Patients ​who present with high platelet counts ​could have a range of benign or malignant disorders, including polycythemia vera, ET, or primary myelofibrosis. Notably, ​patients with ET ​often have a normal lifespan​. As such, if a patient is asymptomatic, ​they do not require immediate therapeutic intervention, Spivak explains. However, these patients should be monitored closely ​for disease progression.

It is important to rule out other causes of high platelet counts, such as iron deficiency, infection, inflammation, or other comorbidities, prior to diagnosing a patient with ET, says Spivak. Should a patient have ET, next-generation sequencing can inform whether a mutation, such as JAK2, CALR, or MPL, caused the disease, Spivak concludes.