How would you approach a low risk patient <60 yo with platelets <600 K, JAK2 positivity and heterozygosity for factor 5 leiden mutation with no previous thrombosis?  

First, some clarification is necessary with respect to the patient's MPN diagnosis because all three MPN can be caused by a JAK2 mutation, but the thrombotic risk is very different in each. Second, this is also a relevant concern because there is no correlation between the platelet count and thrombo...