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Suggest Treatment For Chronic Myeloproliferative Disease
Question: After many years of extensive medical issues for unknown reason, I was at last tested and positive for a jak 2 mutation. I was told it was called myeloproliferative neoplasm and there was appx 4 different things it could be called. then I was sent back to my own health care providers for follow up services.
what should happen next, and then, and then etc.
what should happen next, and then, and then etc.
Brief Answer:
You need treatment of polycythemia vera.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
You have chronic myeloproliferative disease and that is confirmed by jak 2 mutation.
Chronic myeloid leukemia, essential thrombocythemia and polycythemia vera all are included in chronic myeloproliferative disease.
You have polycythemia vera.
In these there is overproduction of RBC and sometimes WBC & platelet also.
So blood becomes more thicker and leads to thrombosis and clotting of blood.
Your portal vein thrombosis, stroke, enlarged spleen and other complications are due to polycythemia vera.
You need treatment for that.
Phlebotomy is the treatment of choice. It is most easy and inexpensive treatment. Aims is to reduce thd hematocrit. Means removal of extra RBCs.
You should take low dose aspirin to prevent thrombosis.
Hydroxyurea can be taken if platelet count increased.
Other newer drugs like anagrelide or erlotinib can be used additionally if required.
These all are prescription based medicine so consult your doctor and take treatment accordingly.
If not treated it can proved fatal so treatment is required.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
You need treatment of polycythemia vera.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
You have chronic myeloproliferative disease and that is confirmed by jak 2 mutation.
Chronic myeloid leukemia, essential thrombocythemia and polycythemia vera all are included in chronic myeloproliferative disease.
You have polycythemia vera.
In these there is overproduction of RBC and sometimes WBC & platelet also.
So blood becomes more thicker and leads to thrombosis and clotting of blood.
Your portal vein thrombosis, stroke, enlarged spleen and other complications are due to polycythemia vera.
You need treatment for that.
Phlebotomy is the treatment of choice. It is most easy and inexpensive treatment. Aims is to reduce thd hematocrit. Means removal of extra RBCs.
You should take low dose aspirin to prevent thrombosis.
Hydroxyurea can be taken if platelet count increased.
Other newer drugs like anagrelide or erlotinib can be used additionally if required.
These all are prescription based medicine so consult your doctor and take treatment accordingly.
If not treated it can proved fatal so treatment is required.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I receive regular phlebotomies, although past history shows drastic intolerance to hydroxyuria. also I take aspirin and Plavix in connection to this. there is also prescribed to me the following: lantus 52 units, glipizide 10mg, nadalol for esophageal vericises from portal vein thrombosis, vit b12 and multivitamin. Question now is, with the basis of polycythemia only on assumption but not any further testing, is it safe to do the treatment that this would dictate? if the true illness was one of the other issues included in the list of jak 2 mutation, would it make it worst to be treated for pv if the issue actually was one of the others or is the treatment for all of them basically the same anyway. What level of need is there for an exact diagnosis which I should insist on further testing that is both likely painful and expensive?
Brief Answer:
Basic treatment is same.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
You have chronic myeloproliferative disease. You have polycythemia vera most likely according to your history.
For exact confirmation peripheral smear examination and bone marrow examination should be done. It will give you exact diagnosis.
Basic treatment is same for all chronic myeloproliferative disease. Aspirin and hydroxyurea is routinely used in all.
If you are intolerant to hydroxyurea then avoid it. Phlebotomy should be done regularly in polycythemia vera however it is not indicated in chronic myeloid leukemia.
Go for peripheral smear examination and bone marrow examination. Then take treatment accordingly.
Its not expensive. Bone marrow examination is slightly painful. Peripheral smear examination needs few drops of blood only.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Basic treatment is same.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
You have chronic myeloproliferative disease. You have polycythemia vera most likely according to your history.
For exact confirmation peripheral smear examination and bone marrow examination should be done. It will give you exact diagnosis.
Basic treatment is same for all chronic myeloproliferative disease. Aspirin and hydroxyurea is routinely used in all.
If you are intolerant to hydroxyurea then avoid it. Phlebotomy should be done regularly in polycythemia vera however it is not indicated in chronic myeloid leukemia.
Go for peripheral smear examination and bone marrow examination. Then take treatment accordingly.
Its not expensive. Bone marrow examination is slightly painful. Peripheral smear examination needs few drops of blood only.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by :
Dr. Yogesh D
thank you for your prompt and throurogh response. you have provided more info in these sessions than i have been able to get from everyone else put together. I have had quite the time in getting anyone interested in doing any further testing of any of the health issues that i have, and i have not yet come to an understanding of why this problem is there. it should have been quite obvious to need to test further when i originally made the statement "but i have only one time ever had high rbc, i am historically quite anemic most of the time" and this should have caused the thought of needing to test further... instead it caused quite a stir of anger with doctor yelling at me and cancelling all further oncology visits, at that paticular hospital's clinics. i have developed quite the fear of all things called medical over the years with0ut being able to gain understanding of some of it and i would like to thank you for nicely assisting on some of the things i have not been able to get answers to, and to do it without causing further fears and complications. one other question is to ask what specialist is the most appropriate to approach for getting these types of tests done.. hematologist or is there a specialty just for researching and testing for possible illness and such. thank you
Brief Answer:
You need further testing which is done pathologist.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Your problem is due to genetic mutation. We can't help in that.
You need further testing. That is sure.
Complete blood count, peripheral smear examination and bone marrow examination is enough to diagnose your problem.
In chronic myeloid leukemia there is very high wbc count. So easily diagnosed or rules out by wbc count only.
Same way in essential thrombocythemia there is very high platelet count.
In polycythemia vera rbc count, hemoglobin and hematocrit are higher. But you are going for regular phlebotomy so it may be normal and that cause doubt in your mind.
But bone marrow examination can easily diagnose polycythemia vera with positive jak 2 mutation.
These tests are prescribed by hematologist and done by hematopathologist (pathologist with specialization in field of hematopathology). Consult your pathologist and go for testing.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
You need further testing which is done pathologist.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Your problem is due to genetic mutation. We can't help in that.
You need further testing. That is sure.
Complete blood count, peripheral smear examination and bone marrow examination is enough to diagnose your problem.
In chronic myeloid leukemia there is very high wbc count. So easily diagnosed or rules out by wbc count only.
Same way in essential thrombocythemia there is very high platelet count.
In polycythemia vera rbc count, hemoglobin and hematocrit are higher. But you are going for regular phlebotomy so it may be normal and that cause doubt in your mind.
But bone marrow examination can easily diagnose polycythemia vera with positive jak 2 mutation.
These tests are prescribed by hematologist and done by hematopathologist (pathologist with specialization in field of hematopathology). Consult your pathologist and go for testing.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you so much. you have been a tremendous help with your information. it makes much of it easier to understand and I appreciate your time and kind answers greatly.. sincerely.....
another question please, would essential thrombocythemia and polycythemia vera be thought of and treated in the same ways? is it appropriate to receive treatment for polycythemia vera if the actual issue was essential thrombocythemia ? thank you
another question please, would essential thrombocythemia and polycythemia vera be thought of and treated in the same ways? is it appropriate to receive treatment for polycythemia vera if the actual issue was essential thrombocythemia ? thank you
Brief Answer:
Anti platelet agent is drug of choice for essential thrombocythemia.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Treatment is almost similar for both. However phlebotomy is the treatment of choice for polycythemia and anagrilide is the treatment of choice for essential thrombocythemia.
Anti platelets agents are also helpful in polycythemia but its useful in high platelets count patients only. So that is the different.
So if you are not taking any anti platelets agents in polycythemia then its not appropriate for essential thromocythemia. However it can be easily diagnosed by very high platelet count.
Hope I have answered your question. If you still have any doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Anti platelet agent is drug of choice for essential thrombocythemia.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Treatment is almost similar for both. However phlebotomy is the treatment of choice for polycythemia and anagrilide is the treatment of choice for essential thrombocythemia.
Anti platelets agents are also helpful in polycythemia but its useful in high platelets count patients only. So that is the different.
So if you are not taking any anti platelets agents in polycythemia then its not appropriate for essential thromocythemia. However it can be easily diagnosed by very high platelet count.
Hope I have answered your question. If you still have any doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
can you tell me, if the polycythemia causes the blood to become too thick, and then they do a phlebotomy, will this causing the blood to not be quite so congested, so to speak, cause more of a risk of loosening clots which would now be free to flow throughout the body and somehow cause more of a risk of things like embolisms and strokes?
Brief Answer:
No, it will not increase the risk of embolism.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Phlebotomy will reduce the extra rbc and reduce the viscosity of blood so it decreases the risk. It will not increase the risk of embolism. So don't worry about that.
Just be relaxed. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
No, it will not increase the risk of embolism.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Phlebotomy will reduce the extra rbc and reduce the viscosity of blood so it decreases the risk. It will not increase the risk of embolism. So don't worry about that.
Just be relaxed. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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