Difference between revisions of "Myeloproliferative neoplasms"
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* enlarged spleen | * enlarged spleen | ||
* increased clotting | * increased clotting | ||
==Polycythemia vera== | |||
*ICD-O: 9950/3 | |||
*Median age: 60 years. | |||
*Median survival: >10years. | |||
*Typical course: | |||
**Prodromal stadium: Mild erythrocytosis. | |||
**Polycythemic phase: Incereased RBC count. | |||
**Post-polycythemic ("spent") phase: Ineffective hematopoiesis, bone marrow fibrosis. | |||
*Transformation in [[AML]] possible (2-3%). | |||
===Morphology=== | |||
*Panmyelosis. | |||
*Many megakaryocytes in bone marrow section. | |||
*Increased cellularity of bone marrow (35-100%). | |||
*Teardrop-RBC cells (dacryocytes) in late stage. | |||
*Fibrosis (reticulin stain). | |||
==Images== | ==Images== | ||
<gallery> | <gallery> | ||
File:Thrombocytosis.jpg | Thrombocythemia. Peripheral blood (WC/Erhabor Osario) | File:Thrombocytosis.jpg | Thrombocythemia. Peripheral blood (WC/Erhabor Osario) | ||
File:Polycythemia_vera,_blood_smear.jpg | Polycythemia vera. Peripheral blood (WC/AFIP) | File:Polycythemia_vera,_blood_smear.jpg | Polycythemia vera. Peripheral blood (WC/Orlandi Mourao) | ||
File:Teardrop Cells smear 2009-09-22.JPG | Teardrop RBC cells in polycythemia vera. Peripheral blood (WC/AFIP) | |||
File:Essential Thrombocythemia, Peripheral Blood (10189570483).jpg | Essential thrombocythemia. Peripheral blood (WC/Ed Uthman) | File:Essential Thrombocythemia, Peripheral Blood (10189570483).jpg | Essential thrombocythemia. Peripheral blood (WC/Ed Uthman) | ||
File:Essential thrombocythemia (2).jpg | Essential thrombocythemia. Bone marrow (WC/KGH) | File:Essential thrombocythemia (2).jpg | Essential thrombocythemia. Bone marrow (WC/KGH) | ||
Revision as of 13:41, 9 December 2015
Myeloproliferative neoplasms, also myeloproliferative disorders, are a group of indolent hematologic neoplasms characterized by clonal expansion of pluripotent hematopoietic progenitor.
These should not be confused with myelodysplastic syndromes (MDS).
Grouping
They include the following:[1]
- Polycythemia vera.
- Essential thrombocythemia.
- Idiopathic myelofibrosis.
Clinic
- moderate to severe anemia
- pale skin
- fatigue
- prolonged bleeding
- enlarged spleen
- increased clotting
Polycythemia vera
- ICD-O: 9950/3
- Median age: 60 years.
- Median survival: >10years.
- Typical course:
- Prodromal stadium: Mild erythrocytosis.
- Polycythemic phase: Incereased RBC count.
- Post-polycythemic ("spent") phase: Ineffective hematopoiesis, bone marrow fibrosis.
- Transformation in AML possible (2-3%).
Morphology
- Panmyelosis.
- Many megakaryocytes in bone marrow section.
- Increased cellularity of bone marrow (35-100%).
- Teardrop-RBC cells (dacryocytes) in late stage.
- Fibrosis (reticulin stain).
Images
Thrombocythemia. Peripheral blood (WC/Erhabor Osario)
Polycythemia vera. Peripheral blood (WC/Orlandi Mourao)
Teardrop RBC cells in polycythemia vera. Peripheral blood (WC/AFIP)
Essential thrombocythemia. Peripheral blood (WC/Ed Uthman)
Essential thrombocythemia. Bone marrow (WC/KGH)
.jpg)
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Molecular
- BCR-ABL1 negative (DDx: Leukemia (BCR-ABL1 positive))
- A specific JAK2 mutation (Val617Phe) in seen in a group of patients.[1][2]
- In JAK2-negative cases, CALR or MPL-Mutations are often found.[3]
See also
References
- ↑ 1.0 1.1 Baxter EJ, Scott LM, Campbell PJ, et al. (2005). "Acquired mutation of the tyrosine kinase JAK2 in human myeloproliferative disorders". Lancet 365 (9464): 1054–61. doi:10.1016/S0140-6736(05)71142-9. PMID 15781101.
- ↑ Steensma DP, Dewald GW, Lasho TL, et al. (August 2005). "The JAK2 V617F activating tyrosine kinase mutation is an infrequent event in both "atypical" myeloproliferative disorders and myelodysplastic syndromes". Blood 106 (4): 1207–9. doi:10.1182/blood-2005-03-1183. PMC 1895198. PMID 15860661. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1895198/.
- ↑ Nangalia, J.; Green, TR. (Dec 2014). "The evolving genomic landscape of myeloproliferative neoplasms.". Hematology Am Soc Hematol Educ Program 2014 (1): 287-96. doi:10.1182/asheducation-2014.1.287. PMID 25696868.