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This booklet provides information about myeloproliferative neoplasms (myelofibrosis, polycythemia vera and essential thrombocythemia) and includes our Myeloproliferative Neoplasm Symptom Assessment Form to help you identify and keep track of your symptoms.
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On average, individuals with essential thrombocythemia (ET) have a normal life expectancy if they are properly monitored and treated. It's important that your doctor is experienced in treating myeloproliferative neoplasms (MPNs) or works in consultation with a hematologist-oncologist who has experience treating MPN patients.
Prevention of blood clots (thrombosis) and bleeding (hemorrhaging) is the main objective of treating patients with ET. For some patients with no signs of the disease at the time of diagnosis (other than an increased platelet count), the risk of complications may be low and therefore no treatment is initially needed. However, patients at high risk for blood clots and bleeding may be prescribed medication right away to reduce their platelet counts.
Treatment planning
Every patient’s medical situation is different and should be evaluated individually by a hematologist-oncologist who specializes in treating blood cancers. It is important for patients and the members of their medical team to discuss all treatment options, including treatments being studied in clinical trials.
Learn more about communicating with your blood cancer specialist or find a list of suggested questions to ask your healthcare providers.
Risk category | Patient characteristics | Treatment approach |
| Very low |
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| Low |
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| Intermediate |
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| High |
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Types of treatment for ET
Any or a combination of the following may be included in treatment for ET. Open each section below to learn more.
Low-dose aspirin
Low-dose aspirin may reduce the risk of clotting complications. Low-dose aspirin helps prevent platelets from sticking together, making blood clots that can cause heart attacks or strokes less likely to form. The most common side effects of aspirin include upset stomach and heartburn. Low-dose aspirin may also increase bleeding risk in patients with extremely high platelet counts. For these reasons, the use of aspirin in treating ET needs to be individualized.
Cytoreductive therapy
This refers to a group of medications that reduce the number of blood cells in the bone marrow:
- Hydroxyurea (Hydrea®)
- Anagrelide (Agrylin®)
- Peginterferon alfa-2a
Learn more about drug therapies.
For information about the drugs listed on this page, visit our cancer drug listing.
Plateletpheresis is a process that uses a special machine to skim platelets from a patient’s blood and then return the remaining blood components to the patient. It is used only in emergency situations, such as acute clotting complications, when the platelet count is very high and needs to be reduced quickly. The platelet-reducing effect of this therapy is temporary.
Patients with ET have an increased risk of blood clots compared with the general population. Your doctor may use imaging tests such as ultrasound, CT scans and MRI scans to look for blood clots in your body.
If you have a blood clot, treatment depends on where the blood clot is located and how likely it is to harm you. Your doctor may prescribe an anticoagulant (blood thinner) to help prevent blood clots from forming. Low-molecular-weight heparin is a class of blood thinners that can be safely self-injected by the patient at home.
Another option is an oral (taken by mouth) blood thinner such as warfarin. For life-threatening blood clots that have already formed, drugs called “thrombolytics” can be given to dissolve them.
Any patient who develops a venous blood clot (blood clot in a vein) requires lifelong treatment with anticoagulants.
Patients with ET should focus on their overall health. A heart-healthy lifestyle may decrease the risk of thrombosis. Lifestyle changes may include:
- Controlling your blood pressure
- Keeping your cholesterol under control
- Managing diabetes
- Not smoking
- Working toward a healthy body weight
- Taking your medications
- Exercising
Discuss healthy lifestyle changes with your doctor. Ask for a referral to a physical therapist for an exercise plan and an oncology registered dietitian for help with nutrition.
Taking part in a clinical trial may be the best treatment choice for some ET patients. Patient participation in clinical trials is important in the development of new and more effective treatments for ET and may provide patients with additional treatment options.
Learn more about clinical trials.
Get free clinical trial support! Visit our Clinical Trial Support Center (CTSC).
Connect with registered nurses with expertise in blood cancers who can personally assist you or your caregiver through each step of the clinical trial process.
There are clinical trials available for ET patients in a number of different situations—whether they are newly diagnosed, have advanced-stage disease, or are intolerant or resistant to their current medications.
Side effects of ET Treatment
The side effects of treatment for ET will depend on many factors, including the type of treatment and dosage, the age of the patient, and coexisting medical conditions.
Patients should discuss any concerns about side effects with their doctor as management of side effects is important. Most side effects are temporary and resolve when treatment is completed
Learn more about EV treatment side effects and how to manage them.
Follow-up care
Find more information about follow-up care, including what to expect, long-term and late effects of treatment, survivorship clinics, and other resources, such as The National Comprehensive Cancer Network (NCCN) treatment guidelines.
Use the Survivorship Workbook to collect all the important information you need throughout diagnosis, treatment, follow-up care, and long-term management of a blood cancer.
Learn more about the long-term and late effects of treatment.
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