The management of malignant thrombocytosis in Philadelphia chromosome-negative myeloproliferative disease: guideline rec

Brief Summary

GUIDELINE TITLE

The management of malignant thrombocytosis in Philadelphia chromosome-negative myeloproliferative disease: guideline recommendations.

BIBLIOGRAPHIC SOURCE(S)

Matthews JH, Smith CA, Herst J, Lee D, Imrie K, Hematology Disease Site Group. The management of malignant thrombocytosis in Philadelphia chromosome-negative myeloproliferative disease: guideline recommendations. Toronto (ON): Cancer Care Ontario (CCO); 2008 Jan 15. 30 p. (Evidence-based series; no. 6-9). [50 references]

GUIDELINE STATUS

This is the current release of the guideline.

The EVIDENCE-BASED SERIES report, initially the full original Guideline, over time will expand to contain new information emerging from their reviewing and updating activities.

Please visit the Cancer Care Ontario Web site for details on any new evidence that has emerged and implications to the guidelines.

BRIEF SUMMARY CONTENT

RECOMMENDATIONS
EVIDENCE SUPPORTING THE RECOMMENDATIONS
IDENTIFYING INFORMATION AND AVAILABILITY
DISCLAIMER

Go to the Complete Summary

RECOMMENDATIONS

MAJOR RECOMMENDATIONS

All essential thrombocythemia (ET) and polycythemia vera (PV) patients with thrombocytosis should be managed with low-dose aspirin. Special precautions should be taken in the case of patients with greater bleeding risk or allergies (see "Qualifying Statements" field for additional information).

Management without cytoreductive therapy is a reasonable option for asymptomatic patients.

Cytoreductive therapy should be considered as an option for patients with thrombocytosis who have thrombosis. Hydroxyurea is the preferred agent and should be administered to maintain a platelet count of less than 600 x 10⁹/L (see "Qualifying Statements" field for additional information).

If treatment with hydroxyurea is not appropriate, then either interferon or anagrelide are options. Physicians who choose anagrelide to reduce the risk of arterial thrombosis should be aware that there are data suggesting that it is inferior to hydroxyurea, and its efficacy in comparison to no cytoreductive therapy has not been established. Other than reducing the platelet count, interferon is of unknown efficacy.

CLINICAL ALGORITHM(S)

None provided

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EVIDENCE SUPPORTING THE RECOMMENDATIONS

TYPE OF EVIDENCE SUPPORTING THE RECOMMENDATIONS

The recommendations are supported by retrospective, prospective, randomized controlled trials, and clinical practice guidelines.

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IDENTIFYING INFORMATION AND AVAILABILITY

BIBLIOGRAPHIC SOURCE(S)

Matthews JH, Smith CA, Herst J, Lee D, Imrie K, Hematology Disease Site Group. The management of malignant thrombocytosis in Philadelphia chromosome-negative myeloproliferative disease: guideline recommendations. Toronto (ON): Cancer Care Ontario (CCO); 2008 Jan 15. 30 p. (Evidence-based series; no. 6-9). [50 references]

ADAPTATION

Not applicable: The guideline was not adapted from another source.

DATE RELEASED

2008 Jan 15

GUIDELINE DEVELOPER(S)

Program in Evidence-based Care - State/Local Government Agency [Non-U.S.]

GUIDELINE DEVELOPER COMMENT

The Program in Evidence-based Care (PEBC) is a Province of Ontario initiative sponsored by Cancer Care Ontario and the Ontario Ministry of Health and Long-Term Care.

SOURCE(S) OF FUNDING

Cancer Care Ontario
Ontario Ministry of Health and Long-Term Care

GUIDELINE COMMITTEE

Provincial Hematology Disease Site Group

COMPOSITION OF GROUP THAT AUTHORED THE GUIDELINE

For a current list of past and present members, please see the Cancer Care Ontario Web site.

FINANCIAL DISCLOSURES/CONFLICTS OF INTEREST

Not stated

GUIDELINE STATUS

This is the current release of the guideline.

The EVIDENCE-BASED SERIES report, initially the full original Guideline, over time will expand to contain new information emerging from their reviewing and updating activities.

Please visit the Cancer Care Ontario Web site for details on any new evidence that has emerged and implications to the guidelines.

GUIDELINE AVAILABILITY

Electronic copies: Available in Portable Document Format (PDF) from the Cancer Care Ontario Web site.

AVAILABILITY OF COMPANION DOCUMENTS

The following are available:

The management of malignant thrombocytosis in Philadelphia chromosome-negative myeloproliferative disease: guideline recommendations. Summary. Toronto (ON): Cancer Care Ontario (CCO), 2008 Jan. 3 p. (Practice guideline; no. 6-9). Electronic copies: Available in Portable Document Format (PDF) from the Cancer Care Ontario Web site.
Browman GP, Levine MN, Mohide EA, Hayward RSA, Pritchard KI, Gafni A, et al. The practice guidelines development cycle: a conceptual tool for practice guidelines development and implementation. J Clin Oncol 1995;13(2):502-12.

PATIENT RESOURCES

None available

NGC STATUS

This summary was completed by ECRI Institute on July 16, 2008. The information was verified by the guideline developer on August 20, 2008.

COPYRIGHT STATEMENT

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions. Please refer to the Copyright and Disclaimer Statements posted at the Program in Evidence-based Care section of the Cancer Care Ontario Web site.

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DISCLAIMER

NGC DISCLAIMER

The National Guideline Clearinghouse™ (NGC) does not develop, produce, approve, or endorse the guidelines represented on this site.

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Guidelines represented on the NGC Web site are submitted by guideline developers, and are screened solely to determine that they meet the NGC Inclusion Criteria which may be found at http://www.guideline.gov/about/inclusion.aspx .

NGC, AHRQ, and its contractor ECRI Institute make no warranties concerning the content or clinical efficacy or effectiveness of the clinical practice guidelines and related materials represented on this site. Moreover, the views and opinions of developers or authors of guidelines represented on this site do not necessarily state or reflect those of NGC, AHRQ, or its contractor ECRI Institute, and inclusion or hosting of guidelines in NGC may not be used for advertising or commercial endorsement purposes.

Readers with questions regarding guideline content are directed to contact the guideline developer.

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Brief Summary

GUIDELINE TITLE

BIBLIOGRAPHIC SOURCE(S)

GUIDELINE STATUS

BRIEF SUMMARY CONTENT

RECOMMENDATIONS

MAJOR RECOMMENDATIONS

CLINICAL ALGORITHM(S)

EVIDENCE SUPPORTING THE RECOMMENDATIONS

TYPE OF EVIDENCE SUPPORTING THE RECOMMENDATIONS

IDENTIFYING INFORMATION AND AVAILABILITY

BIBLIOGRAPHIC SOURCE(S)

ADAPTATION

DATE RELEASED

GUIDELINE DEVELOPER(S)

GUIDELINE DEVELOPER COMMENT

SOURCE(S) OF FUNDING

GUIDELINE COMMITTEE

COMPOSITION OF GROUP THAT AUTHORED THE GUIDELINE

FINANCIAL DISCLOSURES/CONFLICTS OF INTEREST

GUIDELINE STATUS

GUIDELINE AVAILABILITY

AVAILABILITY OF COMPANION DOCUMENTS

PATIENT RESOURCES

NGC STATUS

COPYRIGHT STATEMENT

DISCLAIMER

NGC DISCLAIMER

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