Onkológia 4/2018
Esenciálna trombocytémia – mení sa niečo v diagnostike a liečbe v roku 2018?
Essential thrombocytemia – is there any change in diagnostics and treatment in the year 2018?
Modern diagnostics of essential thrombocytemia (ET) needs molecular genetic tests for assessment of prognosis, and histologic examination for better distinguishing from similar diseases as prepolycytemic phase of PV (pre-PV) or prefibrotic phase of PMF (pre-PMF). Treatment of ET differs in various parts of Europe. In the West cytostatics as hydroxyurea and busulfan are preferred before interferon (IFN) or anagrelide (ANA). In Scandinavia IFN is the drug of 1st choice for ET treatment. In Central and Eastern Europe ANA and IFN are preferred for cytostatics. These differences are given by the different release form of ANA available in various countries as well as in the difference in IFN availability. ANA preparation available in the West has different pharmakokinetics which leads to more frequent and worse adverse events. Recently generics of ANA have become available in Slovakia. But they correspond to the “western” type of ANA and therefore must not be considered as a substitution of the drug available in Slovakia (Thromboreductin). Further improvement of ET treatment can be awaited from the slow release form of ANA. Its approval by EMA is awaited soon.
Keywords: essential thrombocytemia, myeloproliferative neoplasms/disorders, anagrelide, interferon, thrombophilia, thrombosis, genetic examination, bone marrow histology
