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Fortunately, prognosis in ET and PV is relatively good, with median survivals in younger patients estimated at 33 and 24 years, respectively. Therefore, when it comes to treatment in ET or PV, less is more and one should avoid exposing patients to new drugs that have not been shown to be disease-modifying, and whose long-term consequences are suspect (e.g., ruxolitinib). Furthermore, the main indication for treatment in ET and PV is to prevent thrombosis and, in that regard, none of the newer drugs have been shown to be superior to the time-tested older drugs (e.g., hydroxyurea). We currently consider three major risk factors for thrombosis (history of thrombosis, <jats:italic>JAK2<\/jats:italic>\/<jats:italic>MPL<\/jats:italic> mutations, and advanced age), in order to group ET patients into four risk categories: \u201cvery low risk\u201d (absence of all three risk factors); \u201clow risk\u201d (presence of <jats:italic>JAK2<\/jats:italic>\/<jats:italic>MPL<\/jats:italic> mutations); \u201cintermediate-risk\u201d (presence of advanced age); and \u201chigh-risk\u201d (presence of thrombosis history or presence of both <jats:italic>JAK2<\/jats:italic>\/<jats:italic>MPL<\/jats:italic> mutations and advanced age). Herein, we provide a point-of-care treatment algorithm that is risk-adapted and based on evidence and decades of experience.<\/jats:p>","DOI":"10.1038\/s41408-017-0041-8","type":"journal-article","created":{"date-parts":[[2018,1,10]],"date-time":"2018-01-10T10:51:29Z","timestamp":1515581489000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":100,"title":["Essential thrombocythemia treatment algorithm 2018"],"prefix":"10.1038","volume":"8","author":[{"given":"Ayalew","family":"Tefferi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro M.","family":"Vannucchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziano","family":"Barbui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2018,1,10]]},"reference":[{"key":"41_CR1","doi-asserted-by":"publisher","first-page":"2391","DOI":"10.1182\/blood-2016-03-643544","volume":"127","author":"DA Arber","year":"2016","unstructured":"Arber, D. 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