DÄ internationalArchive4/2008Essential Thrombocythemia – Clinical Significance, Diagnosis and Treatment: Pipobroman Gets Regulatory Approval Outside Germany

Correspondence

Essential Thrombocythemia – Clinical Significance, Diagnosis and Treatment: Pipobroman Gets Regulatory Approval Outside Germany

Dtsch Arztebl Int 2008; 105(4): 71-2; DOI: 10.3238/arztebl.2008.0071d

Tsamaloukas, A G

LNSLNS Regarding the etiology and pathogenesis of essential thrombocythemia (ET), the authors refer to the fact that clonality analyses only allow the detection of clonal hematopoiesis in about two thirds of all patients. This finding is obtained by detection of the JAK2V617F mutation, which is itself also a marker of clonality, in about 50% of patients. This heterogeneity of ET gives rise to the question whether patients with polyclonal ET are also stratified in terms of risk and hence require medicinal therapy (1).

Polymorphism of the thrombopoietin receptor (Mpl) has been described as one and certainly a rare cause of essential thrombocytosis (2). How would the authors treat such a patient? The tabulated overview of the various therapies for ET raises the question as to which modality is capable of eradicating this cell clone in the presence of the JAK2V617F mutation? In this context, the literature citation offers the possibility of evaluating pipobroman, which is approved and available – e.g., in Italy and France – for the management of polycythemia and ET. Long-term data on the leukemogenic risk of pipobroman in ET are available and have not shown any increased risk of leukemia in ET (3).

Finally, it should be mentioned that research has already been commenced into the function of platelets and their disorders using proteomic methodologies as a valuable means of further elucidating and describing the genetic changes observed in ET.
DOI: 10.3238/arztebl.2008.0071d

Dr. med. Antonis G. Tsamaloukas
Facharzt für Innere Medizin
Schulstr. 16–18, 40721 Hilden, Germany
tsamaloukas@onkologe-hilden.de

Info

Specialities