MF Treatments

[Armanimick]

Hubby, 67 diagnosed MF out of the blue 2 month ago is on "watch and wait" taking 75mg of Asprin. He gets headaches (May not be related but asked doctor) who said his most recent platelet count is 701x109/L 8/4/14 compared to 563x109/L 6/2/14 a month back. Dr said if this persists then it would sway him towards a trial of treatment and suggests we talk about hydroxycarbamide when we visit in two weeks....can anyone help with blood count translation. ? Some sites infer this is still relatively low... Hubby doesn't want to take drugs for the sake if it.... Thank you people....

[skodaguy]

OK this would be easier with haemoglobin and white cell counts also. MF is a condition of bone marrow failure, normal platelet counts are 150-450. All hospitals use a standard reporting range so the volume figure i.e. x109/L just confuses matters. MF can be either a primary disease or arise because of another blood condition, such as ET or PV. Does your husband have an enlarged spleen? Has he had a bone marrow biopsy. If not this could be thrombocytosis, a condition in which platelets are over produced. The risk is that high platelet counts are associated with thrombotic events i.e. clots in places that matter. This is made worse if your husband has a history of vascular disease, smokes, has diabetes etc. Also any cancer increases the risk of a thrombotic event.

Aspirin acts by making platelets less likely to stick to each other which is the first stage of clot formation. Hydroxycarbide (HU) suppresses bone marrow production so it will reduce platelet counts but can also reduce haemoglobin production which can lead to anaemia and also white count production which leads to immunosuppression and increased risk of infection.

750 is significant as you are more likely to have a thrombotic event with increased age just because of the increased risk that goes with ageing. How fit is your husband as exercise reduces the risk of thrombotic events?

MF is one of a group of diseases called myeloproliferative neoplasms, neoplasm is doctor speak for cancer and myeloproliferative just means abnormally active bone marrow. It seems actually illogical that MF is in this group as it is a state of failure not over activity but it can be a consequence of it.

The more you see of this group you will realise that MPN's are probably the most diverse group of cancers with so many other complications that it is not surprising if your husband's consultant seems uncertain. Even the best consultants see some of us with groups of conditions they have never seen or could have been taught about. Thus uncertainty about the right path to take is inevitable. Sometimes that means in the modern medico-legal atmosphere you are asked to make decisions you are less capable then them of making. I hope this helps you to understand the situation you are in.

[Armanimick]

Dear Skoda guy, thank you for this and for your message....we have an appointment in two weeks, his last was just under 3 months ago when he was diagnosed. We were told nothing of his counts, spleen size etc. Dr said after routine blood tests and a previous BMB you have MF, leaflets given and from their finding out what we can. I wrote to doc asking about his headaches and this is when we got the figures, impressive service, he responded to my email 2 days later ( 2 days ago) suggesting HU etc. so in readiness for his appt, I am asking more questions. 2 years back he had Bell's palsy with a count of 580, and letter said Dr to follow up on high platelets to ensure it is due to inflammation....it obviously was not and appears he had I diagnosed ET then...past is past so now moving forward on MF. Mike has no symptoms apart from tiredness and headaches so to go straight to HU is rather frightening. Thank you for listening and taking time to respond....grateful.

[Mazcd Partner MPNVoice]

Hi Armanimick, I have asked Prof Harrison for you and she has said that - this is a high platelet count normal is 150-400. Sometimes high platelet counts can cause symptoms like headaches etc though usually this would respond to aspirin it may not always do. Also, the platelet count can fluctuate, for example it may go up with an infection. So you are doing the right thing in having questions ready to ask the consultant when you next see him, this will all help you make the decision about starting any new medication. Kind regards, Maz.

[Armanimick]

Thank you Maz, appreciated and I cannot believe how questions are responded too, all of the time, a real help....I really am getting so much help and hope to help others going forward.