NCCN Guidelines for Patients® | Myeloproliferative Neoplasms

27 NCCN Guidelines for Patients ® : Myeloproliferative Neoplasms, 2018 Monitoring After initial treatment, you will need to meet with your doctor often. A visit every 3 to 6 months is advised. You may need more frequent visits if problems arise. Guide 3 list the types of monitoring for each risk group. Status of ET Your doctor will assess if the ET is worse. Blood tests may be done. You may complete the MPN-SAF Total Symptom Score. This survey consists of 10 symptoms. Fatigue is also queried. Each symptom is rated on a scale from 0 to 10. Higher scores point to worse symptoms. Need for cytoreductive treatment Initial treatment for very-low, low-, and intermediate- risk groups doesn’t include cytoreductive treatment. During monitoring, your doctor will check if you need to start. Signs that treatment may be needed include: † † A new blood clot, † † Acquired VWD, † † Major bleeding, † † Increasing spleen size, † † Symptoms caused by enlarged spleen, † † Symptoms caused by too many platelets, † † Rising levels of white blood cells, † † Worsening MPN symptoms, and † † Aspirin isn’t relieving symptoms. Cytoreductive treatment is described on page 26. Before starting, a bone marrow aspirate and biopsy should be done. These tests can show if the cancer has progressed to MF. If it has, the treatment described in Part 5 is needed. 3 Essential thrombocythemia Monitoring Guide 3. Monitoring ET by risk group Type of care Very Low Low Intermediate High • Assess status of ET • Assess need for cytoreductive treatment • Assess results of cytoreductive treatment