Hi everyone I’ve just been for my 4 month appointment with my haematologist and my platelets have increased from 375 to 460. He wants me to come back in 2 months time and then if platelets not reduced my hydroxycarbemide will be increased. I’m on 9 tablets a week for ET aged 71 and fit. I’m not keen on increasing the dose and I’m due soon for my 2nd dose of Shingrix . Might the vaccine effect my platelet level. My flu jab is due as well and I’m wondering how to space all these vaccines .
Also when increasing hydroxycarbemide will I get more side effects and lose more hair and be more at risk of skin cancer?
I would appreciate your thoughts. Thanks Irene
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Na56
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Infections can cause reactive thrombocytosis. Platelets can cycle by as much as 100K in s single day based on what is happening in your body, This is normal platelet function. A rise to 460 should not be a significant concern unless it was part of a pattern of an upward trend that was sustained over time in the absence of a known case of reactive thrombocytosis.
I always space my vaccines out by a few weeks. I tend to get stronger adverse effects when I combine them.
Hydroxycarbamide adverse effects are dose dependant. higher risk would be assumed with a higher dose. You would have to determine if the increased risk is justified by increased benefit.
Suggest you review your treatment goal for treating your case of ET with your MPN care team. Note that many MPN experts now state there is no particular value to having PLT "normal" for ET. Many MPN Specialists now individualize goals. Some use 600 as the target. Others consider the delta (degree of change) to be more significant. Others use other targets. You will have to decide what is appropriate for your case.
Thank you so much for this information Hunter. I did say to my haematologist that a lot of experts allow patients to have platelets of up to 600. He said that sometimes the hydroxycarbemide wouldn’t work to bring peoples platelets below such a number but the worldwide opinion was that platelets should be below 400. Since June 2022 when I increased the tablets to 9 a week I’ve had four counts in the 400s and two in the 300s. Up and down they go. I do like the idea of an individual plan of treatment possibly with joint care with a specialist so I’m not pushed into more hydroxycarbemide unless absolutely necessary. I do want to talk about peg interferon for which I would definitely want joint specialist care. Thanks again Irene
Suggest reviewing your case with a MPN Specialist for up-to-date information on treatment for ET. Here is a link mpnforum.com/list-hem./ Suggest reviewing your treatment goal and approach with a MPN Specialist to get the individualized plan that is optimal for you.
Read what Hunter5582 has to say, but also know that the effects of any given vaccination on any given patient can be variable, and I found more references to vaccines causing reactive thrombocytopenia [lowered platelet levels] than I did to vaccine-related thrombocytosis [even though I already knew that it was a thing even before I looked].
As Hunter also stated, increasing the dosage of any given medication can increase the possibility and severity of side-effects, and not necessarily in a linear manner. [i.e., even small dosage increases can trigger increased side-effects...]
As we so often ask here:
Is your hematologist an MPN specialist? or a general Heme/Onc MD?
If you're interested in a specialist consultation, a 2nd opinion, or even changing MD's, take a look here for an MPN specialist near you:
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Symptoms with platelet count ~500?
Is peg interferon always slow to reduce platelet count? 
Platelet count
Hydroxycarbamide and platelet count: is my experience so far typical?
