New aspirin guidelines

[Ashtin]

I am 67, diagnosed with PV, and taking daily low dose aspirin along with HU.I'm reading today that USPSTF (Physician task force) is no longer recommending low dose aspirin to protect against heart attacks and strokes. They are saying the risk of bleeding in the brain, stomach and intestines, though low, increases with age. With that being said, are the MPN specialists weighing in as to the benefit versus risk?

[Barbiebreath]

I’ve only been diagnosed with PV since January but when I asked my hematologist/oncologist ( not a MPN specialist) about taking aspirin she did not recommend it because of the reasons you stated. I am taking it anyway because it seems to be a part of a lot of PV patient's treatment. 🤷‍♀️ That may change when I see a specialist .

[EPguy]

The report was qualified that older patients with heart disease are still candidates. We have a different disease, but likely still fits there in a way.

Also, aspirin is an anti inflammatory which I believe is one reason it's routinely Rx for us, since MPN is inflammatory.

One detail, in my case my 1st Dr Rx 2- 81mg/day, and my MPN specialist reduced it to 1/day. But I recall he indicated some PV patients are best on 2/day.

It all leads to our, and Dr's, idea for best practice, but my guess is most MPNs will still be candidates for at least some aspirin.

[hunter5582]

Actually there is disagreement about this in the MPN Community. Most MPN Specialists do recommend that patients with ET/PV take low dose aspirin. Some are now following the age>60 = higher risk of bleeding and other symptoms protocol. That is, unless there is another reason to need the aspirin.

When I was seeing Dr. Spivak, he recommended I discontinue the aspirin as I was 63 and had a history of excessive hemorrhage on aspirin. He said, you really do not want to get a brain bleed. Two weeks later I was was diagnosed with a hemorrhagic brain tumor. Oops! Now three years and one brain surgery later, I have started back on aspirin, by my choice. i started getting significant pain in my toes/feet - a classic PV microvascular symptom. I decided to opt for an even lower dose (40.5 mg) of aspirin. The microvascular symptom disappeared immediately and no excessive hemorrhage. it is the right answer for me.

Like all things MPN, we are each different. We each need an individualized treatment plan. The answer to aspirin is not black and white. it depends. It depends on your MPN profile, treatment goals, risk tolerance and preferences. Suggest you review the risk/benefit analysis for yourself with a MPN Specialist. The make up your own mind.

[Barney50]

A little background - I am 72, diagnosed with PV - JAK2 positive at 69. My hematocrit at diagnosis was 68. The PV was found during pre-knee replacement surgery testing. No other symptoms at time of diagnosis - quite a surprise! I have not had any strokes, heart attacks, bleeds or blood clots. I have had an effusion on my knee that was caused by a hard bump to the knee. I am on Jakafi - 5mg 2x daily and 1-81 mg aspirin. My hematologist recommended I stay on the aspirin because it addresses the problem of the “stickiness” of the platelets. My hematocrit number has been stable at 37-39 for the last 16 months. For me, the aspirin is something I will continue with. Your doctor has his reasons for treatment protocols but we all need to ask questions, do solid research and weigh the risk/benefit of our treatments.