Hi @gigi05 You’re getting some great question suggestions from our helpful members! I can toss in info on the JAK2 mutation for you. We tend to pick up mutations along our life journey for whatever reason. Our bone marrow produces several million cells per second! Each with staggering precision. So even one tiny glitch in a strand of DNA can change the course of your history. A cool statistic I picked up recently from an outstanding book on the history of bone marrow transplantation. Our body produces 200 billion red cells, 400 billion platelets and 10 billion wbc daily! Mind blowing, at least it was for me.

Here are some go-to articles that I recommend for anyone wanting to learn about the JAK2 mutation and what it can mean for developing an MPN such as PV, ET or MF.

From Verywellhealth:
https://www.verywellhealth.com/jak2-mutation-5217909
From Healthline:
https://www.healthline.com/health/myelofibrosis/what-is-the-jak2-gene
From Pub Med:
https://pmc.ncbi.nlm.nih.gov/articles/PMC6721738/
While some mutations aren’t considered hereditary in themselves, there can be familial lineage that may factor into how your body handles a mutation or making it more prone to happening. Does that make sense?

Just that I had been on Anagrelide for 16/17 years, with only tiredness. Platelets always came under control while on it. Found out that there isn'tmuch differencebetweenboth these drugs, Hu being a chemotherapy tablet and Anagrelide not. Now on HU for 3 months, all good so far tiredness and a bit of sun sensitivity so far. Good luck with your Dr.

I just learned that my JAK2 is positive. I spoke with my oncologist before the test results were finished. He said he had talked to the hematologist and it wouldn’t change the diagnosis for the medication and how we move forward.

@gigi05
My oncologist/hemo also told me it is not hereditary and I was not born with it. I took him to mean ET but he could have meant the gene mutation. I am JAK2 positive and was diagnosed with ET in April at age 77 with a platelet count of 581k. Was put on a low dose aspirin a day and told I'd have to go on a chemo pill (presumably HU) if it went above 600k, but at the last check it had, for some unknown reason, gone down a little to the 540s. That's the only time it's ever gone down since it started rising a couple of years ago.

I also wonder why the question about alternatives to HU. From the considerable reading I've done about ET, HU is the standard protocol for treating it and seems to be the treatment that is better tolerated by most people and has the fewest unwanted side effects, for most people.

Thank you for sharing what you learn and prayers and best wishes for a good outcome.