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Below is what Google AI has to say:

Triple-negative essential thrombocythemia (ET) is a subtype of ET characterized by the absence of three common driver mutations:
JAK2 (Janus kinase 2) V617F, CALR (calreticulin) mutation, and MPL (MPL501L) mutation.
Prevalence:
Triple-negative ET is relatively rare, accounting for approximately 10-20% of ET cases.
Pathogenesis:
The exact cause of triple-negative ET is unknown. However, it is believed to be a clonal hematopoietic disorder, similar to other types of ET, but without the identifiable driver mutations.
Clinical Features:
Triple-negative ET patients typically present with:
Elevated platelet count, Often asymptomatic, and May have a lower risk of thrombosis compared to other ET subtypes.
Diagnosis:
The diagnosis of triple-negative ET is based on the following criteria:
Sustained platelet count above 450 x 10^9/L
Absence of JAK2, CALR, and MPL mutations
Exclusion of other hematological disorders
Prognosis:
Triple-negative ET is generally considered an indolent disease with a favorable prognosis. However, some patients may develop complications such as thrombosis or bleeding.
Treatment:
Treatment for triple-negative ET is typically individualized based on the patient's risk factors. Options may include:
Observation with regular monitoring
Low-dose aspirin to prevent thrombosis
Cytoreductive therapy (e.g., hydroxyurea) if there is an increased risk of thrombosis