Haematology

Question 1

Outline the treatment options for Essential Thrombocytopenia

Answer 1

1) Aspirin
2) Hydroxycarbamide (*)
3) Anagrelide (Specifically inhibits platelet function but rarely used because of side effects)
(*) Note: Hydroxycarbamide is an Antimetabolite that suppresses cell turnover

Question 2

What might you see on a primary myelofibrosis blood film

Answer 2

1) Leucoerythroblastic picture
2) Tear drop poikilocytes (dacrocytes)
3) Giant platelets
4) Circulating megakaryocytes

May cause Budd-Chiari syndrome

Question 3

Outline the treatment options for Primary Myelofibrosis

Answer 3

1) Conservative/Supportive- RBC and Platelets transfusion, often ineffective due to splenomegaly

2) Medical a. Hydroxycarbamide- could worsen anaemia b. Ruxolitinib- JAK2 inhibitor.

3) Surgical- a. Allogenic stem cell transplant b. Splenectomy- risky operation but may provide symptomatic relief