Impact of World Health Organization (WHO) Revised Criteria-2016 on the Diagnosis of Polycythemia Vera

Nathany, Shrinidhi; Laxminarayana, Sindhura Lakshmi Koulmane; Tewari, Siddharth; Belurkar, Sushma; Khanna, Ruchee; Manohar, Chethan

doi:10.1007/s12288-019-01202-w

Cited by 2 publications

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References 17 publications

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“…The first focus point of discussion on the updated diagnostic criteria in 2016 is the lowering cutoff value in Hct and Hb for a major criterion 11 . A strong relationship between Hct and Hb levels and PV diagnosis has been debated in the literature 8,[12][13][14][15] .…”

Section: Discussionmentioning

confidence: 99%

“…The most crucial aspect of the updated criteria in 2016 was to identify masked and clinically suspected cases 10,12 . Changing Hct and Hb thresholds in 2016 made some changes and was shown in a study to cause a 36% increase in the diagnosis of PV over the 2008 version 11 . In a study in which 2,056 suspected MPN patients were evaluated, 132 patients were diagnosed with the WHO 2008 criteria, while 154 patients were diagnosed with the WHO 2016 criteria 10 .…”

Section: Discussionmentioning

confidence: 99%

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Updated threshold, renewed problems: should the diagnostic criteria of polycythemia vera be reconsidered? A retrospective cross-sectional cohort study

Uçan,

Özgeyik

2024

Rev. Assoc. Med. Bras.

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OBJECTIVE: This aim of this study was to evaluate hemoglobin and hematocrit values of polycythemia vera and secondary polycythemia patients with updated World Health Organization thresholds. In addition, by determining our own threshold values, we aimed to demonstrate the necessity of bone marrow biopsy and genetic analysis to be used for further diagnosis in patients with high-normal hematocrit and hemoglobin values. METHODS: A cross-sectional and retrospective study was performed with the medical records of patients from Eskisehir City Hospital hematology clinics and outpatient clinics between July 1, 2019 and July 1, 2020. The study included patients with polycythemia, divided into two groups according to polycythemia vera and secondary polycythemia. A bone marrow biopsy was performed on patients with either Janus kinase mutation positivity and/or subnormal erythropoietin levels. Receiver operating characteristics analysis was used to find threshold values, and the diagnostic efficiency of these values in differentiating World Health Organization thresholds in 2008 and 2016 was evaluated. RESULTS: A total of 73 patients were included. The median age was 43.5 years (min: 18; max: 84). The hematocrit value of 54.1 was predicted to diagnose polycythemia vera with a sensitivity of 45% and a specificity of 80%. Subsequent analysis revealed that an hemoglobin value of 17.7 was indicative of diagnosing polycythemia vera with a sensitivity of 60% and a specificity of 63%. The mean follow-up length was 6.4 months (2-12). CONCLUSION: Our study demonstrated that modified World Health Organization criteria might lead to unnecessary additional tests for polycythemia vera patients with high-normal hemoglobin and hematocrit values.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Updated threshold, renewed problems: should the diagnostic criteria of polycythemia vera be reconsidered? A retrospective cross-sectional cohort study

Uçan,

Özgeyik

2024

Rev. Assoc. Med. Bras.

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Assessment of megakaryocytes’ size and morphology in selected myeloproliferative neoplasms

et al. 2022

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Introduction: Contemporary technological development make the cytological analysis of megakaryocytes (MKs) a valuable tool for supporting differential diagnosis of myeloproliferative neoplasms’ (MPNs) early stages. Aim: The aim of the study was to identify megakaryocyte’s cytological differences between chronic myelogenous leukemia (CML), polycythemia vera (PV) and essential thrombocythemia (ET), as well as to assess the usefulness of this analysis in differential diagnosis of the aforementioned MPNs. Materials and methods: Bone marrow aspirate smears were obtained from 20 patients with CML, 15 patients with PV and 12 patients with ET. The control included bone marrow biopsies from 15 patients without any hematological disorder. The following megakaryocyte’s parameters were examined: cell diameter, cytoplasmic area, nuclear area, nuclear-cytoplasmic ratio and nuclear lobulation. Results: Cytological analysis revealed a significantly decreased megakaryocytes’ size and the prevalence of cells with hypolobulated nuclei in CML patients comparing to other groups. MKs in ET were found to have characteristic staghorn-like hyperlobulated nucleus, whereas polycythemia vera showed the predominance of cells with multilobulated nuclei (4-7 lobes) and a tendency to hyperlobulation. However, there were no significant differences in mean values for cytoplasmic and nuclear area among these two groups of patients. Conclusion: Characteristic megakaryocytes’ cytological differences in CML patients may be useful in differential diagnosis of the CML’s early stage. MKs’ size and nuclear-cytoplasmic ratio are not useful in differentiation between polycythemia vera and essential thrombocythemia.

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Impact of World Health Organization (WHO) Revised Criteria-2016 on the Diagnosis of Polycythemia Vera

Cited by 2 publications

References 17 publications

Updated threshold, renewed problems: should the diagnostic criteria of polycythemia vera be reconsidered? A retrospective cross-sectional cohort study

Updated threshold, renewed problems: should the diagnostic criteria of polycythemia vera be reconsidered? A retrospective cross-sectional cohort study

Assessment of megakaryocytes’ size and morphology in selected myeloproliferative neoplasms

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