A case report describes a child who had a high platelet count, a condition called isolated thrombocytosis. The child was first treated with hydroxyurea and aspirin, but did not improve. Further testing revealed the child had chronic myeloid leukemia (CML), a type of blood cancer, caused by the BCR::ABL1 fusion gene. The child was then given imatinib, a targeted therapy for CML, and achieved a complete cytogenetic response within 4 months. This means the cancer cells with the abnormal gene were no longer detectable.
This is a single case report, so the findings may not apply to all children with high platelets. The authors suggest that all children with unexplained high platelets should be tested for the BCR::ABL1 gene to avoid missing a CML diagnosis. However, this recommendation is based on just one case, and more research is needed.
No side effects or safety issues were reported in this case. The main takeaway is that when a child has high platelets that do not respond to usual treatments, testing for CML may be helpful. But this is not a reason to change standard practice without further evidence.
