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Hesitant on starting Hydrea for ET Jak 2
I am a 73 year old female, diagnosed with ET, with Jak 2 mutation. The highest my platelet count has been was in the mid 600's and was just tested again today at High 500's. As of now I am on 2 baby asprins a day, but my Oncologist has been recommended me starting Hydrea since I was diagnosed 2 years ago. I am hesitant about starting Hydrea because I have no ET symptoms, worried about the side effects of Hydrea and the fact that my platelet count has not been climbing. My WBC and RBC are on the high side of normal and I am also concerned they will be negatively effected. What did other oncologists order when their patient's platelets were in the high 500's? Interested in hearing comments.
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@jville42
It's not podcasts or AI that should guide your decision about treatment.
Listen to your oncologist. Only she or he knows what's best for you.
Sadly, our cancer is so rare that it's way over the heads of many general practitioners. This delays diagnosis for many of us. I'm so glad you have now found an experienced specialist.
ET is not something to ignore. It's what's causing your fatigue, and it puts you at higher risk of blood clots. Being active and healthy is always great, but no matter how much you exercise, you cannot undo the JAK mutation that causes ET.
Just some background of possible interest to the question above--Why aren't we all on Besremi?
ET patients are typically in their 60s when diagnosed. Pegasys, the first interferon approved for MPNs often caused intolerable depression in patients over 60. I had a small support group with several patients who tried it but could not tolerate it. A few said the depression did not dissipate even after going off Pegasys, and they were on anti-depressants. In addition, it was expensive and, since not approved for ET, very expensive.
So, Pegaysys was recommended for those under 40, who did not have depressive side effects, used cautiously in those 40-60, and used only in those over 60 if hydroxyurea failed.
Fast-forward to Besremi, second generation interferon: the drug seems better tolerated than Pegasys, and doctors learned better dosing techniques from their patient's experience with Pegasys.
However, Besremi is still not approved for ET, and so is prohibitively expensive for most of us.
As far as I know, hydroxyurea has never been officially approved for ET, either, but because it's a cheap generic that most patients tolerate and has well-known side effects, insurance usually pays for it.
Until Besremi shows superior outcomes than hydroxurea, is approved by the FDA, or goes generic (at least 20 years), my guess is that insurance companies will continue to keep it out of their pharmacopias for ET.