How do you decide the dose of aspirin to use in MPN patients?

The standard dose for aspirin in the USA for MPN patients is aspirin 81 mg daily. I sometimes use 81 mg BID for patients with significant CV comorbidities. Some patients with headaches or microcirculatory symptoms may improve symptomatically with BID aspirin. Lastly, patients with erythromelalgia wi...

In patients with PV, there is phase 3 data showing benefit with 100 mg of aspirin daily (Landolfi et al., PMID 14711910), so based on availability in the US, 81 mg daily is the most commonly used. Of note, older studies of high doses of aspirin (900 mg) showed increased gastrointestinal bleeding (Ta...