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Dr. David
Dr. David, Board Certified Physician
Category: Medical
Satisfied Customers: 45619
Experience:  Experienced Physician trained in New York City. I'm ready to help.
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My husband was diagnosed with ET after a heart attack on

Customer Question

My husband was diagnosed with ET after a heart attack on 9/11. Angio and ECG was clear. However, blood work showed elevated platelets, WBC, Netro, Esino and decreased lymphocytes. He was started on hydrea a week ago and is responding adversely to it. Is there a different or less invasive drug he can be prescribed instead?
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. David replied 1 year ago.

This is Dr. David

yes, there are other treatments such as Anagrelide (Agrylin) which isn't associated with an increased risk of leukemia, but is not considered as effective as hydrea. Side effects may include fluid retention, heart problems, headaches, dizziness, nausea and diarrhea.

also Interferon alfa (Intron A) or pegylated interferon alpha 2a (Pegasys) is given by injection and is used to treat ET. it may be more expensive but can be the best choice for some people

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Customer: replied 1 year ago.
I don't understand why chemo dugs would be used to treat ET when it has the possibility of mutating into CML.I have transferred him from the small hospital he was diagnosed at to Stanford so he can work with the best people for this condition. His appt. is October 20th. Do I run a risk of taking him off Hydrea and keeping him on aspirin/lopressor until he can get a second opinion and possibly talk about alternatives like Agrylin? What about a protein kinase inhibitor like Imatinib?
Expert:  Dr. David replied 1 year ago.

ET is a type of bone marrow cancer where the bone marrow cells which make platelets have become cancerous and are dividing too much and making too many platelets.

that is why chemotherapy and immune modulating drugs are used.

interferon is an immune modulating treatment.

I would keep him on hydrea for now until he sees a specialist

Imatinib is used to treat Philadelphia translocation positive CML,

his ET hasn't mutated in CML I take it.

untreated ET can eventually mutate into CML, but I take it his hasn't yet.

I take it he has seen a hematology oncologist so far and has had a bone marrow biopsy already.