{'fraction_non_alphanumeric': 0.03394762366634336, 'fraction_numerical': 0.026188166828322017, 'mean_word_length': 5.0498533724340176, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
PREGNANCY IN WOMEN WITH ESSENTIAL THROMBOCYTHAEMIA

We read with interest the paper by Shpilberg et al (1996) on the transient normalization of platelet count and the uneventful outcome of pregnancy in two women with essential thrombocythaemia (ET) treated with -interferon (IFN). Two points, however, require comment. A spontaneous fall in platelet count often occurs in normal pregnancy. In the available literature a decrease in platelet count is reported in the majority of cases of ET during pregnancy, even without any treatment (Beard et al, 1991). In our experience we observed an average decrease in platelet count of 56% (range 44–70%) in five pregnancies in four women with ET who attended our department throughout pregnancy (unpublished data). Increase of blood volume (Cairns et al, 1977), higher concentration of oestrogen and adrenocortical hormones (Kaibara et al, 1985) or the release of a factor from the placenta or uterus that down-regulates platelets production (also reported by Shpilberg et al, 1996) have been proposed as mechanisms responsible. Consequently the hypothesis that a decreased production of neutralizing antibodies to IFN during pregnancy could lower platelet count for the proportional increased IFN effectiveness is not tenable. As to the use of -IFN in pregnant women with ET, we wish to point out that only very few anecdotal reports are available. Excluding the present series, only six cases are described: four quoted by Shpilberg et al (1996) and an additional two reported by Pardini et al (1995) and Perez Encinas et al (1994). In four of these cases acetyl salycilic acid (ASA) was administered during the pregnancy. Furthermore, in our extensive experience (13 pregnancies in 10 women with ET, unpublished data), and in accordance with the reports of other authors, uneventful delivery can occur without any cytoreductive treatment (Beard et al, 1991; Beressi et al, 1995; Randi et al, 1994). A definite proposal on the best treatment, if any, to be offered to pregnant women with ET cannot be given at present.