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A 7 LJ-year-old male with h istory of coronary and peripheral arterial disease presents to the emergency departmen t complaining of a painful. blue. fourth righ t toe . Patien t reports progressively worsening dark blue discoloration over the last 3 days. Patien t also reports several mon ths of burning sensation in h is hands and feet and left upper quadran t discom fort. Laboratory workup reveals leukocyte count of 1 5 .200/,LLL. he-moglobin of 1 LJ.6 g/d l. and platelet count of 82 5 .000/,LLL. Peripheral blood smear and bone marrow aspirate are shown below.
What would be the most appropriate management of this patient?
- Aspirin
- Hydroxyurea
- Anagrelide
- Aspirin and hydroxyurea
- Aspirin and anagrelide
Medicine
D. Patient falls into a high-risk category based on his age (greater than 60) and the presence of coronary and peripheral arterial disease. Thus, current evidence suggests that treatment with hy-droxyurea and aspirin would constitute the most appropriate choice (J Clin Oneal. 20 1 1;29(6):761).
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