本態性血小板血症

Treatment―guideline, outcome, prognosis：essential thrombocythemia

　本態性血小板血症は骨髄増殖性新生物の中では比較的予後良好な疾患であり，その合併症である血栓症・出血の管理が最も重要である．リスク因子として年齢60歳以上，血栓症・出血の既往，血小板数150万/μl以上が挙げられ，リスクに応じた治療を行う．治療として経過観察，抗血小板療法(アスピリン)，血小板減少療法(ヒドロキシウレアなど)，時に血小板吸着療法などが行われる．妊娠希望者および妊婦に対しては早期から産婦人科医との連携を綿密に行い，リスクを考慮しアスピリンや低分子ヘパリン，インターフェロンなどの治療を行う．

Essential thrombocythemia is a myeloproliferative neoplasm that usually has a good prognosis. However, critical management is essential to prevent complications such as thrombosis and hemorrhage. Prudent treatment is required in patients with risk factors, such as age over 60 years, history of thrombosis and hemorrhage, and platelet level over 150×10⁴/μl. Treatment include observation, antiplatelet therapy(acetylsalicylic acid), thrombocytopenic therapy(hydroxyurea, etc.), and plateletpheresis. In pregnant women or those planning to become pregnant, treatment with acetylsalicylic acid, low molecular weight heparin, or interferon is initiated from the early stages of pregnancy in consultation with the OB/GYN to reduce maternal complications such as miscarriage, stillbirth and abruption.