First of all, thanks to Magg for posting the ET paper by Prof Harrison.
As a decidedly non-expert in the field of medical terminology, it has taken me some time to plough through it (time well spent) and extract the parts that are relevant to me, so I thought I would share my notes and seek comments on whether they are in the right ball park.
As context, I am 73 with ET JAK+ and have been on hydroxycarbomide (HC) for about 6 years. Having initially struggled with severe fatigue initially, presumably whilst I adapted to HC, I am now stable (it's probably pushing it to say 'normal'!) and on a dosage of 6500mg / 13 tablets pw.
What I took from the paper, from a personal perspective, was:
1. Of the drugs available, HC provides the best outlook for ET patients for those able to tolerate it. (that was a surprise to me as i had thought of HC as the cheap and old school solution)
2. ~20% of ET patients become resistant / intolerant of HC - therefore the vast majority (80%)do not
3. Resistant / intolerant patients have an increased risk of thrombosis, hemorrhage and disease progression / transformation to PET-MF / AML (although I could not find / understand any quantification to indicate the extent of this risk)
4. Ruxolitinib is not superior to other second-line treatments for ET
I would appreciate your thoughts
John