Essential thrombocythemia and pregnancy.

+39.79.228375. Fax. international +39.79.228282. Received January 17, 1995; accepted February 27, 1995. Sir, the management of essential thrombocythemia (ET) in young patients is still controversial and represents an intriguing problem especially, during pregnancy. We have read with interest the article by Radaelli et al., which reports a concise review of published data on the course of pregnancies in ET, and we would like to add a brief description of our experience. The main data on six pregnancies in four woman affected by ET are shown in Table 1. In case #1, the first pregnancy ended in a late spontaneous abortion, and the high platelet count found at the time was interpreted as reactive thrombocytosis. A diagnosis of ET was made several months later and therapy with ainterferon (a-IFN) was started. The patient became pregnant for a second time during IFN therapy and continued this treatment for two months. After this period, low doses of aspirin (ASA; 100 mg/day) were started and maintained until the delivery. The second patient was diagnosed with ET during pregnancy and did not receive any treatment. The third patient, who was resistant to recombinant and natural IFN, refused any further treatment and returned to our observation at the eighth week of gestation with an internal abortion. During a second pregnancy she was treated with ASA (100 mg/day) and delivered a fullterm, healthy male infant without complications. The placenta weighed 500 g and did not show any infarctual areas. The fourth patient became pregnant during remission obtained with a-IFN therapy, which was stopped two months before conception. A low platelet count was maintained without therapy throughout the entire pregnancy and the patient delivered a full-term baby. During the postpartum period the platelet count gradually increased and, after two months, we had to start a-IFN treatment again. This is the first case reported in the literature where a remission obtained with a-IFN lasted long enough to allow a normal course of pregESSENTIAL THROMBOCYTHEMIA AND PREGNANCY