ET and platelet rich plasma treatment

[Amethist]

Recently saw an orthopaedic specialist about an old sports injury to my knee and one of his recommendations was PRP treatment. Just wondered if anyone on here has had experience with this treatment or even if this is a viable option for someone with ET. I would be very interested to hear from you.

[Planti]

I have ET with the JAK2 mutation. I am on Pegasus 45.5ug every two weeks. I had PRP prolotherapy for hip with consent from my MPN specialist. My platelets and other blood results are all in the normal range and remained so after the two injections.

It is not an insured service here. It has helped reduce the pain although I remain on a wait list for hip replacement. I have osteoarthritis in most joints so my situation is different. It may not be a sure thing but worth a try if your MPN caregiver agrees.

Good luck and hope you find relief. Cheers, Lauren

[Amethist in reply to Planti]

Many thanks Lauren. Interesting to know your specialist was ok with it. That’s positive 👍

[Penpal21]

I had PRP for a cranky knee a few years before my ET diagnosis. Only had one treatment - didn’t find it helpful. Perhaps should have gone for more treatments 🤷‍♀️ Physio is now recommending prolotherapy for same knee after having knee replacement three and a half years ago as recovery not gone well. I believe PRP and prolotherapy are two different types of treatments? Haven’t cleared with my hemotologist yet though.

[PhysAssist in reply to Penpal21]

This may help some to better understand the differences and similarities...

Infographic for Prolo-therapy and Plasma-Rich Platelet Therapy

[Amethist in reply to PhysAssist]

thank you !

[Amethist]

Thank you. Always interesting to hear how other folk have got on with treatments. I’ve not heard of prolotherapy, so I’ll look that up.

[light]

Hi there, I am with ET Jak2+ and I did have PRP some years go 2013 for about over year. At the time I was on Hu taking 500mg every day. After over year of treatment I had to stop because it did not working. Now I know it was due to that I was taking Hu every day so my platelets were going dow but for what I understand my blood was full of Hu and it would not work for that reason. 2014 I had total hip replacement and now my left hip is not good either. This is my experience. Wishing you well.

[Amethist in reply to light]

many thanks Light. Very helpful to read your experience.

It does seem ( for obvious reasons in reality) that any medication we take for our platelets is going to diminish any possible positive effect of this treatment. I’m only on aspirin, but looking at the research papers, it’s recommended that people come off these for quite some time, before and after treatment.

I think I will have to consider the other options, not PRP.

[PhysAssist in reply to light]

Hi Light.,

It may also be that since HU is a general and very nonspecifically chemo-toxic drug, which interferes with cellular reproduction by non-selectively disrupting DNA synthesis, it just prevented you from healing in a more general sense.

I have found that since I got off of it, my healing process have gradually returned to their previous baseline- mostly.

Best,

PA

Also: "A Systematic Review on the Effect of Common Medications on Platelet Count and Function: Which Medications Should Be Stopped Before Getting a Platelet-Rich Plasma Injection?"

Which states: "Aspirin, acetaminophen, and nonselective NSAIDs should be considered for suspension before a PRP injection because of their potential to diminish the effects of the injection. COX-2–selective NSAIDs and statins do not need to be withheld before a PRP injection...

...patients taking 60-mg/d aspirin had a mean platelet aggregation of 18% compared with 79% in control patients. On the other hand, Feuring et al 11 found that daily treatment with 100-mg/d aspirin failed to significantly decrease platelet aggregation-

[Editorial Comment: That last result/comment seemed crazy, because that's the whole reason we MPN'ers take it].... but the discussion portion of the article shed some further light onto the subject:

"This unexpected finding might be explained by these patients’ coronary artery disease, which may have confounded the results. In addition, this cohort was significantly older than those in other studies. A previous study by Vaturi et al 41 showed that age was independently correlated with decreased aspirin responsiveness in patients with coronary artery disease and that patients aged 75 years or older exhibited higher rates of aspirin resistance. "

Three studies found that aspirin treatment did not lead to a significant change in platelet count. Interestingly, Erhart et al 10 found that healthy patients treated with 250-mg/d aspirin for 7 days displayed an increased platelet count."

Source: ncbi.nlm.nih.gov/pmc/articl...

[Penpal21 in reply to PhysAssist]

Thanks for all the info ! Appreciate your time.