Essential Thrombocythemia: Making treatment decisions

Posted by mamsgirl1998 @mamsgirl1998, Jan 27 7:26pm

I have ET and was diagnosed 2 years ago. I am 50 Years old and my latest platelet count was 1,183,000. I only take a baby aspirin daily. My hematologist said I could try Hydroxyurea if I wanted. I am low risk and at first I didn’t want to take it. My platelet count continues to climb. I am thinking about trying the medication. Anyone else tried it? Any ill side effects?

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@winmil99

do you have Jak 2 mutation?

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Yes. ET w/JAK2

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71 yo female diagnosed Jan 2023. At my highest, platelets were 680. Now holding in the low 600’s.

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I was diagnoses with ET Jak2 in jaune 2024, I am 70, jog and exercise daily, vegetarian. no weight problems. I was told I should be on low dose asa and HD 500 daily as my plt numbers were in the 500's. I balked at the HD and then was told I could wait until I hit 600 for the HD. I get lab monthly my plt have been over 600 x 2 months. y Dr now says I dont have to worry about clotting until they hit 1 million..I am assuming the 600 is really 600000. As much as I do not want to take HD, I am nervous about clotting...Thought?

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@winmil99

I was diagnoses with ET Jak2 in jaune 2024, I am 70, jog and exercise daily, vegetarian. no weight problems. I was told I should be on low dose asa and HD 500 daily as my plt numbers were in the 500's. I balked at the HD and then was told I could wait until I hit 600 for the HD. I get lab monthly my plt have been over 600 x 2 months. y Dr now says I dont have to worry about clotting until they hit 1 million..I am assuming the 600 is really 600000. As much as I do not want to take HD, I am nervous about clotting...Thought?

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Hello,
I didn’t start on HD until mine hit 842. After 3 months I’m down to 210. I was taking 500mg once daily now he changed it on the 29th Feb 2024 to 400 mg daily. I was not ready to take meds even when I was at 842. It took a month after the prescription. I have ET Jak2 as well.

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@winmil99

I was diagnoses with ET Jak2 in jaune 2024, I am 70, jog and exercise daily, vegetarian. no weight problems. I was told I should be on low dose asa and HD 500 daily as my plt numbers were in the 500's. I balked at the HD and then was told I could wait until I hit 600 for the HD. I get lab monthly my plt have been over 600 x 2 months. y Dr now says I dont have to worry about clotting until they hit 1 million..I am assuming the 600 is really 600000. As much as I do not want to take HD, I am nervous about clotting...Thought?

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If you have no other underlying health issues, such as myself, just PV My oncologist says a platelet count of 600 or less is completely acceptable. I do take the Hydroxyurea 500 mg just 3X a week now with no side effects. Higher doses will make a difference but most go to lower doses soon after starting and do well.

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@johngrudnowski

I just was diagnosed in early January so have been on Hydroxyurea for ~24 days now. I'm 46 with platelets around ~600 but i had a heart attack 2 years ago so they have me as high-risk. my experience was headaches for the first ~2-3 days with a little bit of nausea (not bad). The headaches went away with some tylenol and then went away (mostly) after the first 3 days.

After that I've settled in a bit but certainly notice muscle fatigue and joint pain more than before. I'm a pretty active person so not sure that is intensifies it. For example pre-Hydrea I lifted weights 3-4 days a week and ran ~30-40 miles a week. I ran 9 miles the other day and have continued my lifting but the best way to describe it is I currently feel 70-80% as strong as a month ago and I feel I need to get more restorative time in the afternoons and then am more "sore" in the morning. I'm told by others on this thread and by doctors that goes away with time on the drug but i haven't reached that point.

Lastly...it's definitely had an impact on my skin. So far it's been bringing out old sunspots on my face (which I've heard is common). Also I am feeling areas of my skin as more sensitive to the sun then before even in ~30-60 seconds in the sun. Not that they are getting burned that quickly but you can just feel the light more intensively. As a result I'm putting essentially full sunblock on my whole body now which is fine and I can live with it but also just something new. To combat this my wife researched that Coconut oil and honey based products are good (someone please tell me if they are not 😉 because I've been now using just a couple different types of creams at night and i'm already noticing the changing skin is stopping or getting back to the way it was.

Beyond that I think the last worth mentioning (at least for me) is the mental side of it. I've personally struggled a bit with the idea that I'll be on a chemo pill the rest of my life and that I may be 70-80% for that time. That may only be me, and likely because this is a new diagnosis for me, but it's probably been the hardest thing for me whether that is a side effect or not. Also something I'll likely get past but honestly it's better than another heart attack or ignoring the problem.

So yeah overall good luck with your decisions. I think you'll find a ton of people on this that forum that have been on Hydroxyurea for a long time. Even 30+ years and are going strong! so on the whole there are some side effects but to they really aren't that bad so far. There is also a good chat within this forum that discusses other alternatives to Hyrdoxyurea which I've personally found interesting.

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After 12 years on hydrea I still struggle with the mental side of taking a chemotherapy drug for the rest of my life. Mostly though, I just try to ignore it. I am still very active but tire more easily now and keep thinking when I was 50 I could do more. I am now 72.
Good Luck!

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When I was 72, I could do more! At 78, I am resigned to doing a little less, especially physical labor! (smile) I didn't start on hydroxyurea as young as you did however. I was 71 or 72 but didn't start getting tired out so much until two years ago when I collapsed a couple of vertebrae and discovered I had osteoporosis and had to take Prolia AND hydroxyurea. Both have many of the same side effects including muscle pain. But I am still upright!

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@sregiani

71 yo female diagnosed Jan 2023. At my highest, platelets were 680. Now holding in the low 600’s.

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what are you taking

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what does my hct have to do with my plt counts

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@winmil99

what does my hct have to do with my plt counts

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Hi @winmil99 HCT (hematocrit) measures how much of your blood consists of red blood cells. Platelets and white blood cells are the other components in your blood.
All of these components are generally proportionally balanced within specific ranges in a healthy person.
When one or more element is either too high or too low, it can be an indication of infection or condition causing the over or under production of blood cells, either red, white or platelets. HCT doesn’t necessarily impact platelets directly but overall, if platelets and red blood counts are out of the norm, it may indicate an underlying health issue.

Here’s a great article about HCT from verywellhealth.com
https://www.verywellhealth.com/hematocrit-level-test-1942505
Are your hemoglobin and HCT elevated along with your platelets?

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