From the FDA Drug Label
The dosage should be adjusted to the lowest effective dosage required to reduce and maintain platelet count below 600,000/µL, and ideally to the normal range.
A platelet count of 799 is within the normal range.
- No adjustment in medication is needed for this platelet count.
- Monitoring of platelet count should continue as per the treatment protocol 1.
From the Research
A platelet count of 799 indicates thrombocytosis, which may be reactive or primary, and management depends on the underlying cause and risk factors, with a focus on reducing thrombotic complications and monitoring for potential myeloproliferative neoplasms 2. The elevation may be due to various conditions, including infection, inflammation, iron deficiency, or bone marrow disorders.
Key Considerations
- Thrombocytosis can be classified as reactive (secondary) or primary (essential thrombocythemia), with different management approaches for each type.
- Reactive thrombocytosis is often encountered in clinical practice and rarely causes vascular complications, whereas primary thrombocythemia is a myeloproliferative neoplasm associated with mutations of genes regulating thrombopoiesis, such as JAK2 2.
- For primary thrombocytosis, especially if related to myeloproliferative disorders, low-dose aspirin (81-100mg daily) is often prescribed to reduce clotting risk, and cytoreductive therapy may be necessary in cases with very high counts or additional risk factors for thrombosis 3.
Management and Monitoring
- Patients with thrombocytosis should stay well-hydrated and avoid situations that increase clotting risk.
- Further investigation is necessary to determine the cause of the elevated count, including complete blood count, peripheral blood smear, inflammatory markers, and possibly bone marrow biopsy if a primary bone marrow disorder is suspected.
- Regular monitoring is essential, as persistent elevation may indicate an underlying myeloproliferative neoplasm that requires specialized hematology care 2.
Treatment Options
- Cytoreductive therapy, such as hydroxyurea, may be used to reduce platelet counts in cases with very high counts or additional risk factors for thrombosis.
- Anagrelide is another agent that can be used to control platelet counts in patients with thrombocythemia 4.