Case Studies in Myeloproliferative Neoplasms - Episode 19

Case 3: Front Line Therapy Options in ET

Experts in essential thrombocythemia review first line treatment options.

Ruben Mesa, MD: Prithviraj, the guidelines offer 3 options as frontline therapy. As I like to say, there’s both the art and the science of medicine. The guidelines help provide the science. The art is which of the medicines you choose. How do you choose between those frontline options in ET?

Prithviraj Bose, MD: Hydroxyurea, pegylated interferon, and maybe even anagrelide could be considered frontline options. However, I do not use anagrelide as a frontline option. I keep it to hydroxyurea and interferon. My view thus far with interferon has been that I tend to offer it if the patient is very young, younger than 40, or if pregnancy is a consideration. Otherwise, I tend to default to Hydrea. As this panel is well aware, the leukemogenicity has never been proven. It sometimes comes up and tends to be an area of some controversy, but since it has never been proven and it is an effective, inexpensive, convenient, and safe drug, I usually go with hydroxyurea.

This transcript has been edited for clarity.