NCCN Guidelines for Patients® | Myeloproliferative Neoplasms

25 NCCN Guidelines for Patients ® : Myeloproliferative Neoplasms, 2018 3 Essential thrombocythemia Initial treatment Some people receive higher doses based on their symptoms versus risk of bleeding. Aspirin has many health benefits. These benefits are described next. Smoking blocks the action of aspirin. You’ll have to quit smoking for aspirin to work. Vascular symptoms Low-dose aspirin is used to relieve vascular symptoms. These symptoms include headaches, dizziness, fainting, and chest pain. There may be abnormal changes in your vision like blind spots. You may also feel “pins and needles” in parts of your body (paresthesia). Vascular symptoms may include changes in your skin. Your legs or hands may turn red and have a painful, burning sensation. This is called erythromelalgia. A red or purplish net-like pattern may appear on your skin. This is called livedo reticularis. Aspirin may help prevent or relieve these skin problems. Other benefits Aspirin is advised to reduce vascular symptoms. However, it may have other benefits. It may prevent blood clots. It may reduce the likelihood of heart attacks and strokes. It may prevent death from cardiovascular causes. Pregnancy Taking aspirin during and shortly after pregnancy is advised. For a low-risk pregnancy, LMWH may be received instead of aspirin for 2 weeks before labor. For a high-risk pregnancy, you may take LMWH with aspirin throughout the pregnancy. Aspirin may be stopped 1 to 2 weeks before labor. LMWH should be stopped 12 to 24 hours before labor. After giving birth, restart treatment for 6 weeks. Surgery You may need surgery while being treated for ET. If so, stop taking aspirin 1 week before surgery. You may restart treatment 24 hours after surgery unless you have a bleeding risk. Observation Observation is a period of testing to watch for changes in status. It is also sometimes called “watch- and wait.” Instead of aspirin, observation is an option for very low- and low-risk cancers. Aspirin may be started if symptoms appear or worsen. Aspirin Most people with ET receive aspirin. It is used to relieve symptoms like headaches, dizziness, fainting, and chest pain. It may also prevent blood clots.

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