FRCPath Haem Part 1 MCQs-Oncology 488

A 68-year-old woman with JAK2 V617F-positive essential thrombocythaemia (ET) is reviewed after developing recurrent spontaneous epistaxis and easy bruising. Her platelet count is 1,780 × 10⁹/L. She has no previous history of bleeding.

Investigations show:

• Hb 126 g/L

• WCC 11.8 × 10⁹/L

• Platelets 1,780 × 10⁹/L

• PT: normal

• APTT: Prolonged

She is not currently taking aspirin or any anticoagulant.

What is the MOST appropriate management?

A. Start plateletpheresis urgently

B. Start hydroxycarbamide immediatly

C. Start anagrelide immediately as first-line cytoreduction

D. Give platelet transfusion to increase the platelet count

E. Start warfarin because ET carries a high risk of thrombosis