Myeloproliferative neoplasm classification: Difference between revisions
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[[Essential thrombocythemia]] | [[Essential thrombocythemia]] | ||
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Megakaryocyte | [[Megakaryocyte]] | ||
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''Major criteria'': | ''Major criteria'': | ||
*[[Platelet]] count > 450,000 per microliter | *[[Platelet]] count > 450,000 per microliter | ||
*[[Bone marrow examination|Bone marrow biopsy]] showing mainly the proliferation of [[Megakaryocyte|megakaryocytes]] with increased number of enlarged and mature [[Megakaryocyte|megakaryocytes]] | *[[Bone marrow examination|Bone marrow biopsy]] showing mainly the proliferation of [[Megakaryocyte|megakaryocytes]] with an increased number of enlarged and mature [[Megakaryocyte|megakaryocytes]] | ||
*Not meeting criteria for other myeloproliferative neoplasms | *Not meeting criteria for other myeloproliferative neoplasms | ||
*Presence of ''JAK2'', ''CALR'', or ''MPL'' mutation | *Presence of ''[[JAK2]]'', ''CALR'', or ''MPL'' [[mutation]] | ||
''Minor criterion'': | ''Minor criterion'': | ||
*Presence of a clonal marker or absence of reactive thrombocytosis | *Presence of a clonal marker or absence of reactive [[thrombocytosis]] | ||
Diagnosis requires meeting all 4 major criteria or the first 3 major plus the 1 minor criterion | Diagnosis requires meeting all 4 major criteria or the first 3 major plus the 1 minor criterion | ||
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[[Primary myelofibrosis]] | [[Primary myelofibrosis]] | ||
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Megakaryocyte | [[Megakaryocyte]] | ||
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''Major criteria'': | ''Major criteria'': | ||
*Presence of megakaryocyte proliferation and atypia with reticulin fibrosis | *Presence of [[megakaryocyte]] proliferation and atypia with reticulin fibrosis | ||
*Not meeting criteria for other myeloproliferative neoplasms | *Not meeting criteria for other myeloproliferative neoplasms | ||
*Presence of ''JAK2'', ''CALR'', or ''MPL'' mutation | *Presence of ''[[Janus kinase|JAK2]]'', ''CALR'', or ''MPL'' [[mutation]] | ||
''Minor criteria'': | ''Minor criteria'': | ||
*Anemia | *[[Anemia]] | ||
*White blood cell count >11,000 per microliter | *[[White blood cells|White blood cell]] count >11,000 per microliter | ||
*Palpable splenomegaly | *Palpable [[splenomegaly]] | ||
*Elevated LDH | *Elevated [[Lactate dehydrogenase|LDH]] | ||
*Leukoerythroblastic smear | *Leukoerythroblastic smear | ||
Diagnosis requires meeting all major criteria and at least 1 minor criterion | Diagnosis requires meeting all major criteria and at least 1 minor criterion | ||
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[[Chronic myeloid leukemia]] | [[Chronic myeloid leukemia]] | ||
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Common myeloid progenitor | Common [[myeloid]] progenitor | ||
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*Presence of BCR-ABL translocation (chromosomes 9 and 22) | *Presence of [[BCR/ABL|BCR-ABL translocation]] ([[Chromosome|chromosomes]] 9 and 22) | ||
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[[Chronic neutrophilic leukemia]] | [[Chronic neutrophilic leukemia]] | ||
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Neutrophil | [[Neutrophil]] | ||
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*Peripheral blood white blood cell count > 25,000 per microliter with rare myeloblasts and no dysgranulopoiesis | *Peripheral blood [[White blood cells|white blood cell]] count > 25,000 per microliter with rare [[Myeloblast|myeloblasts]] and no dysgranulopoiesis | ||
*Bone marrow hypercellularity with increased granulocytes and normal maturation and <5% myeloblasts | *[[Bone marrow]] hypercellularity with increased [[Granulocyte|granulocytes]] and normal maturation and <5% [[Myeloblast|myeloblasts]] | ||
*Not meeting criteria for other myeloproliferative neoplasms | *Not meeting criteria for other myeloproliferative neoplasms | ||
*Absence of genetic rearrangements of ''PDGFRA'', ''PDGFRB'', ''FGFR1'', or ''PCM1-JAK2'' | *Absence of genetic rearrangements of ''PDGFRA'', ''[[PDGFRB]]'', ''[[Fibroblast growth factor receptor 1|FGFR1]]'', or ''PCM1-[[Janus kinase|JAK2]]'' | ||
*Presence of ''CSF3R'' ''T618I'' or other characteristic mutation | *Presence of ''[[CSF3R]]'' ''T618I'' or other characteristic [[mutation]] | ||
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! style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ! style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
[[Chronic eosinophilic leukemia]] | [[Chronic eosinophilic leukemia]] | ||
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Eosinophil | [[Eosinophil granulocyte|Eosinophil]] | ||
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No formal W.H.O. criteria | No formal W.H.O. criteria | ||
*Typically associated with >1,500 eosinophils per microliter in peripheral blood | *Typically associated with >1,500 [[Eosinophil granulocyte|eosinophils]] per microliter in [[Venous blood|peripheral blood]] | ||
*Typically associated with rearrangements of ''PDGFRA'', ''PDGFRB'', ''FGFR1'', ''JAK2'' | *Typically associated with rearrangements of ''PDGFRA'', ''[[PDGFRB]]'', ''[[Fibroblast growth factor receptor 1|FGFR1]]'', ''[[Janus kinase|JAK2]]'' | ||
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[[Mastocytosis]]<ref name="pmid28254862">{{cite journal| author=Valent P, Akin C, Hartmann K, Nilsson G, Reiter A, Hermine O et al.| title=Advances in the Classification and Treatment of Mastocytosis: Current Status and Outlook toward the Future. | journal=Cancer Res | year= 2017 | volume= 77 | issue= 6 | pages= 1261-1270 | pmid=28254862 | doi=10.1158/0008-5472.CAN-16-2234 | pmc=5354959 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28254862 }} </ref> | [[Mastocytosis]]<ref name="pmid28254862">{{cite journal| author=Valent P, Akin C, Hartmann K, Nilsson G, Reiter A, Hermine O et al.| title=Advances in the Classification and Treatment of Mastocytosis: Current Status and Outlook toward the Future. | journal=Cancer Res | year= 2017 | volume= 77 | issue= 6 | pages= 1261-1270 | pmid=28254862 | doi=10.1158/0008-5472.CAN-16-2234 | pmc=5354959 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28254862 }} </ref> | ||
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Mast cell | [[Mast cell]] | ||
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''Major criteria'': | ''Major criteria'': | ||
*Dense multifocal aggregates of >15 mast cells in bone marrow or other | *Dense multifocal aggregates of >15 [[Mast cell|mast cells]] in [[bone marrow]] or other organs | ||
''Minor criteria'': | ''Minor criteria'': | ||
*Presence of '' | *Presence of ''[[C-kit]] D816V'' [[mutation]] | ||
*Expression of CD2, CD25, or both on mast cells | *Expression of [[CD2]], [[CD25]], or both on [[Mast cell|mast cells]] | ||
*Serum tryptase level >20ng/ml when patient is at baseline health | *Serum [[tryptase]] level >20ng/ml when a patient is at baseline health | ||
*Atypical morphology or spindles in >25% of mast cells in bone marrow or other | *Atypical morphology or spindles in >25% of [[Mast cell|mast cells]] in [[bone marrow]] or other organs | ||
Diagnosis requires meeting the one major plus one minor criterion, or 3 minor criteria | Diagnosis requires meeting the one major plus one minor criterion, or 3 minor criteria | ||
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Revision as of 14:37, 18 March 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2] Shyam Patel [3]
Overview
Myeloproliferative neoplasm may be classified according to the World Health Organization into eight subtypes: polycythemia vera, essential thrombocythemia, primary myelofibrosis, chronic myelogenous leukemia, chronic neutrophilic leukemia, chronic eosinophilic leukemia, myeloproliferative neoplasms unclassifiable, and mastocytosis. Each subtypes is based on a distinct malignant cell, and each subtype has different criteria for diagnosis.[1]
Classification
Disease | Cell of origin | W.H.O. Diagnostic criteria |
---|---|---|
Erythroid precursor |
Major criteria:
Minor criterion:
Diagnosis requires meeting all 3 major criterion or the top 2 major plus the 1 minor criterion | |
Major criteria:
Minor criterion:
Diagnosis requires meeting all 4 major criteria or the first 3 major plus the 1 minor criterion | ||
Major criteria:
Minor criteria:
Diagnosis requires meeting all major criteria and at least 1 minor criterion | ||
Common myeloid progenitor |
| |
| ||
No formal W.H.O. criteria
| ||
Variable |
Not meeting criteria for other subcategories | |
Major criteria:
Minor criteria:
Diagnosis requires meeting the one major plus one minor criterion, or 3 minor criteria |
References
- ↑ Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM; et al. (2016). "The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia". Blood. 127 (20): 2391–405. doi:10.1182/blood-2016-03-643544. PMID 27069254.
- ↑ Vardiman JW, Thiele J, Arber DA, Brunning RD, Borowitz MJ, Porwit A; et al. (2009). "The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes". Blood. 114 (5): 937–51. doi:10.1182/blood-2009-03-209262. PMID 19357394.
- ↑ Valent P, Akin C, Hartmann K, Nilsson G, Reiter A, Hermine O; et al. (2017). "Advances in the Classification and Treatment of Mastocytosis: Current Status and Outlook toward the Future". Cancer Res. 77 (6): 1261–1270. doi:10.1158/0008-5472.CAN-16-2234. PMC 5354959. PMID 28254862.