期刊
BRITISH JOURNAL OF HAEMATOLOGY
卷 166, 期 6, 页码 911-919出版社
WILEY
DOI: 10.1111/bjh.12990
关键词
bone marrow histology; myelopoliferative neoplasms; JAK2 V617F; CALR; prefibrotic myelofibrosis
类别
资金
- Spanish Health Ministry Fondo de Investigacion Sanitaria [EC 10-136, PI10/01807, PI13/00557]
- AECC Cataluna, Instituto de Salud Carlos III FEDER [RD09/0076/00036, RD12/0036/0010]
- Pla Director d'Oncologia de Catalunya (XBTC)
- Comissionat per a Universitats i Recerca del department d' Innovacio, Universitats i Empresa de la Generalitat de Catalunya i del Fons Social Europeu
- Sociedad Espanola de Hematologia y Hemoterapia (SEHH)
Bone marrow histology is included in the diagnostic criteria of myeloproliferative neoplasms (MPNs). However, some concerns have emerged about its reproducibility. To evaluate the diagnostic accuracy of histology and to assess its correlation with presence of mutations and clinical outcomes, two pathologists reviewed the bone marrow biopsies corresponding to 211 patients with MPN. Despite the low agreement in the evaluation of individual histopathological characteristics, the concordance among pathologists when establishing the diagnosis was good (Kappa index 0.67). The specificity of histology was 100%, 98.5% and 98% in polycythaemia vera (PV), essential thrombocythaemia (ET) and primary myelofibrosis (PMF), respectively, whereas the sensitivity of histological diagnosis was low in PV and ET (32.5% and 54% respectively) and acceptable in PMF (75%). Thirteen out of 146 (9%) patients with clinical ET were diagnosed as prefibrotic PMF. No histological agreement or MPN otherwise unspecified was more frequently observed in JAK2 V617F-positive ET than in CALR-mutated cases, whereas megakaryocytic abnormalities and prefibrotic PMF were more frequently observed in CALR-mutated ET. In conclusion, histological criteria of MPN have a limited diagnostic accuracy due to low sensitivity. Patients with JAK2 V617F-positive MPN have a heterogeneous histology while CALR-positive ET is associated with megakaryocyte abnormalities and prefibrotic PMF.
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