Who Diagnostic Criteria Myelofibrosis
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Transcript of Who Diagnostic Criteria Myelofibrosis
World Health Organization (WHO) Diagnostic Criteria for Primary Myelofibrosis (PMF), Polycythemia Vera (PV), and Essential Thrombocythemia (ET)1
Check off the major and minor criteria corresponding to a patient’s clinical presentation. Add the number of check marks in the HIGHLIGHTED criteria in each column and compare the result against the totals required to meet WHO guidelines for diagnosis of each myeloproliferative neoplasm (MPN).
CML = chronic myelogenous leukemia; EPO = erythropoietin; LDH = lactate dehydrogenase; MDS = myelodysplastic syndrome; MPN = myeloproliferative neoplasm; WHO = World Health Organization
aFor PV: or JAK2 exon 12 mutation; for ET: or other clonal marker or no evidence of reactive thrombocytosis; for PMF: or other clonal marker or no evidence of reactive marrow fibrosis.
bPresence of megakaryocyte proliferation and atypia (small to large megakaryocytes with an aberrant nuclear/cytoplasmic ratio and hyperchromatic, bulbous, or irregularly folded nuclei and dense clustering). In the absence of significant reticulin fibrosis, the megakaryocyte changes must be accompanied by an increased bone marrow cellularity characterized by granulocytic proliferation and often decreased erythropoiesis (ie, prefibrotic cellular-phase disease).
cAnd no or little granulocyte or erythroid proliferation.dFor PV: bone marrow trilineage myeloproliferation.eOr other evidence of increased red cell volume as follows: Hemoglobin or hematocrit >99th percentile of method-specific reference range for age, sex, altitude of residence, or hemoglobin >17 g/dL in men, >15 g/dL in women if associated with a documented and sustained increase of at least 2 g/dL from a person’s baseline value that cannot be attributed to correction of iron deficiency or elevated red cell mass >25% above mean normal predicted value.
REFERENCES 1. Tefferi A, Vardiman JW. Leukemia. 2008;22:14-22.
© 2014, Incyte Corporation. All rights reserved. EDU-1147 04/14 | Learn more at MPNConnect.com
PRIMARY MYELOFIBROSIS (PMF) POLYCYTHEMIA VERA (PV) ESSENTIALTHROMBOCYTHEMIA (ET)
SOURCE CRITERIA Major criteria Minor criteria Major criteria Minor criteria Major criteria
Genetics and other considerations
Presence of JAK2V617F or other clonal markera
Not meeting WHO criteria for CML, PV, MDS, or other myeloid neoplasm
TOTAL NUMBER OFHIGHLIGHTED CRITERIA
To meet WHO diagnostic criteria
for this MPN »
Must have at least » 3 2 2 1 4
Or »Hemoglobin
> 18.5 g/dL in men,> 16.5 g/dL in women
2
Clinical examination Palpable splenomegaly
Bone marrow biopsy
Proliferation and atypia of megakaryocytes, with or without
b
Megakaryocyte proliferation with large and mature morphologyc
Myeloproliferationd
Complete blood count
Anemia
Hemoglobin > 18.5 g/dL in men, > 16.5 g/dL in womene
Platelet count ≥450 x 109/L
Biochemistry
Subnormal serum EPO level
Increased serum LDH
Leukoerythroblastosis
Special assay Endogenous erythroid colony growth
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