4.2.1 Initial cytoreductive therapy – hydroxyurea/hydroxycarbamide treatment

Hydroxyurea/hydroxycarbamide is frequently used in the first few weeks to reduce the WBC count and/or the platelet count to safer levels. Hydroxyurea should be switched to a TKI as soon as the patient has decided which TKI to take.

In cases with markedly elevated platelet counts it may be necessary to use anagrelide for the first few days or weeks before an appropriate TKI is selected.