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Proposed revisions to the WHO diagnostic criteria for PV

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There had been different set of criteria in the past to diagnosis. There were the PV study group diagnostic criteria. Most recently, what's mostly used was the WHO criteria which require hemoglobin more than 18.5 in men or 16.5 in female and the presence of JAK2V617 or JAK2 exon 12, the cloning marker. Those are the two major criteria. Then the minor criteria include bone marrow findings that are consistent with MPN such as hypercellularity, megakaryocyte clustering, low serum EPO, and endogenous erythroid colony formation in vivo. Those are the current criteria and you either have two major or you have one major and two minor. The proposal for revision by the WHO includes changing the threshold for hemoglobin to 16.5 in male and 16 grams per deciliter in female. And obviously presence of a JAK2 mutation remained. The proposal for the revision includes the suggestion to move the bone marrow findings as well to a major criterion. The only minor criteria that will remain would be the low serum EPO level.

Most of the cases actually, if they are straightforward, you will make the diagnosis by the presence of erythrocytosis and the JAK2 mutation. You probably don't need the bone marrow to make the diagnosis.

head shot of Dr Komrokji
Rami S Komrokji, MD Clinical Director of the Malignant Hematology Department Moffitt Cancer Center | Tampa, FL
Dr Rami Komrokji is a senior member of the Malignant Hematology and Experimental Therapeutics Program at the Moffitt Cancer Center and is a professor in medicine and oncologic sciences at the University of South Florida’s College of Medicine. Dr Komrokji has authored or co-authored more than 80 peer-reviewed manuscripts, 20 book chapters, and more than 200 abstracts on hematologic malignancies and is a peer reviewer for such medical journals as Blood, Journal of Clinical Oncology, and Leukemia. Dr Komrokji serves as a member on the MDS Panel of the National Comprehensive Cancer Network® (NCCN®).