From the Research
Management of a patient with slightly elevated platelet count (thrombocytosis) and normal hemoglobin typically involves identifying the underlying cause before initiating specific treatment, with a focus on observation and periodic complete blood count monitoring for mild reactive thrombocytosis without symptoms. The first step should be a thorough clinical evaluation to determine if this is reactive thrombocytosis (secondary to infection, inflammation, or iron deficiency) or primary thrombocytosis (from a myeloproliferative disorder) 1. For mild reactive thrombocytosis without symptoms, observation with periodic complete blood count monitoring is usually sufficient, as platelet counts often normalize once the underlying condition resolves. No specific medication is typically needed for asymptomatic patients with slightly elevated platelets. Some key points to consider in the management of thrombocytosis include:
- Identifying the underlying cause of thrombocytosis
- Ruling out essential thrombocythemia or other myeloproliferative disorders with bone marrow biopsy and JAK2, CALR, and MPL mutation testing if thrombocytosis persists or worsens
- Considering low-dose aspirin (81-100 mg daily) for patients with risk factors for thrombosis to reduce clotting risk
- Being aware of potential interferences with platelet count measurements, such as cytoplasmic fragments of leukaemic cells or lipid particles, which can lead to inaccurate results 2, 3. It is also important to note that slightly elevated platelet counts alone rarely cause complications, and unnecessary treatment may introduce more risks than benefits, as highlighted in recent studies 1, 2.