Practice guidelines for the therapy of essential thrombocythemia. A statement from the Italian Society of Hematology, the Italian Society of Experimental Hematology and the Italian Group for Bone Marrow Transplantation

Haematologica. 2004 Feb;89(2):215-32.

Abstract

Background and objectives: The Italian Society of Hematology (SIE) and the two affiliated Societies (SIES and GITMO) commissioned a project to develop guidelines for the therapy of essential thrombocythemia (ET) using evidence-based knowledge and consensus formation techniques.

Design and methods: Key questions on the optimal management of ET patients were formulated by an Advisory Council (AC) and approved by an Expert Panel (EP) composed of 7 senior hematologists. The AC systematically reviewed the published literature from 1980 to August 2002, and articles were graded according to their internal validity and quality. Using the Delphi technique, the EP was asked to answer the key questions according to the available evidence. From September 2002 to March 2003, four Consensus Conferences were held in accordance with the Nominal Group Technique with the goal of solving residual disagreement on recommendations.

Results: The EP provided recommendations on when to start platelet-lowering therapy, the most appropriate platelet-lowering agent, the use of anti-platelet therapy, and the management of women in childbearing age and of pregnant women.

Interpretation and conclusions: By using evidence and consensus, recommendations for the treatment of key problems in ET have been issued. Statements are graded according to the strength of the supporting evidence and uncertainty is explicitly declared.

Publication types

  • Consensus Development Conference
  • Guideline
  • Practice Guideline
  • Review

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Alkylating Agents / adverse effects
  • Alkylating Agents / therapeutic use
  • Cell Transformation, Neoplastic
  • Child
  • Clinical Trials as Topic
  • Cohort Studies
  • Disease Progression
  • Evidence-Based Medicine
  • Female
  • Fibrinolytic Agents / therapeutic use
  • Hemorrhage / prevention & control
  • Humans
  • Hydroxyurea / adverse effects
  • Hydroxyurea / therapeutic use
  • Infant, Newborn
  • Leukemia, Myeloid / etiology
  • Leukemia, Myeloid / prevention & control
  • Male
  • Middle Aged
  • Platelet Aggregation Inhibitors / adverse effects
  • Platelet Aggregation Inhibitors / therapeutic use
  • Pregnancy
  • Pregnancy Outcome
  • Survival Analysis
  • Thrombocythemia, Essential / drug therapy*
  • Thrombocythemia, Essential / therapy
  • Thrombophilia / complications
  • Thrombophilia / genetics
  • Thrombosis / prevention & control
  • Treatment Outcome

Substances

  • Alkylating Agents
  • Fibrinolytic Agents
  • Platelet Aggregation Inhibitors
  • Hydroxyurea