Treatment indications and choice of a platelet-lowering agent in XXXX .

@entity1 @entity137 @entity455 @entity548 @entity1862 @entity44615 @entity117 @entity1863 @entity432 @entity4407 @entity18829 @entity715
The therapeutic strategy in @entity1 with @entity4407 ( @entity4407 ) is a difficult balance between the prevention of bleeding and @entity715 complications and the risks of @entity137 and @entity137 . @entity548 is rare and seems to be related to higher platelet counts. Therefore, a platelet count greater than 1500 x 10(9)/L is generally regarded as an indication for cytoreduction. @entity715 complications include @entity432 , which are usually reversible with low-dose @entity117 , and large vessel @entity715 . The risk of major @entity715 is higher in @entity1 with @entity4407 who are older than 60 years and who have had a previous occlusive event. In this high-risk group, the nonalkylating agent @entity1862 significantly reduces the rate of @entity455 and has emerged as the treatment of choice. However, the long-term risk:benefit ratio of @entity1862 remains disputed because its leukemogenic potential has not been ruled out. This holds also for other myelosuppressive agents such as @entity1863 and @entity44615 . Other drugs of particular interest for young @entity1 include recombinant interferon-alpha and anagrelide. Both of these drugs are effective in lowering platelet counts, but their efficacy in reducing clinical complications remains to be demonstrated. Furthermore, interferon and @entity18829 have frequent and clinically important side effects. Thus, further clinical studies are required to establish their role in the management of @entity1 with @entity4407 .
