Essential thrombocythaemia (ET): lines of therapy
5 standard-of-care settings across 4 lines and 2 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
| Line | All comers | Risk group |
|---|---|---|
| Screening, prevention and diagnosis | 1 | · |
| Early / localised | · | 2 |
| Second line | 1 | · |
| Other settings | 1 | · |
Screening, prevention and diagnosis
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Diagnosis | Full blood count, JAK2, CALR and MPL testing, bone marrow biopsy to confirm ET and exclude prefibrotic myelofibrosis, and exclusion of reactive causes (iron deficiency, inflammation, infection, splenectomy). | 52 |
Early / localised
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| Risk group | Very low and low risk | Observation alone in very low risk (under 60, no clot, JAK2-negative); low-dose aspirin for low risk and for anyone with microvascular symptoms, once acquired von Willebrand deficiency is excluded at very high platelet counts. | 28 | ||
| Risk group | High risk (over 60 with JAK2 or prior clot) | Cytoreduction to a platelet count under 400 x 10^9/L: hydroxyurea first line (PT-1), pegylated or ropeginterferon alfa-2b preferred under 60 and in pregnancy, anagrelide second line. | 75 |
Second line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Progression to myelofibrosis | Managed as myelofibrosis: JAK inhibitors for spleen and symptoms, transplant for fit higher-risk patients. | 87 |
Other settings
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Hydroxyurea resistance or intolerance | Switch to interferon or anagrelide; ruxolitinib did not beat best available therapy in MAJIC-ET but relieves symptoms. | 87 |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.