NEW PROPOSED WHO CRITERIA FOR THE PV DIAGNOSIS: A CLINICAL OVERLOAD PROBLEM?
(Abstract release date: 05/19/16)
EHA Library. Moreno Vega M. 06/09/16; 134929; PB2029
Mrs. Melania Moreno Vega
Contributions
Contributions
Abstract
Abstract: PB2029
Type: Publication Only
Background
There are controversies regarding on which cell parameter may be more conveniently used as a surrogate criteria of an increased red cell mass (RCM), that is, hemoglobin (HB) level and hematocrit (HCT) value. According to the 2007/2008 WHO classification, HB level should be >18.5 g/dl in men and >16.5 g/dl in women and/or increased HCT. It has been argued that application of these criteria may result in an underdiagnosis of PV by excluding patients with actual RCM mass that is 25% above mean predicted value, but whose HB and HCT levels are below the WHO guidelines. Therefore, recently the WHO revised the criteria and in 2015 made a new proposal lowering the HB/HCT threshold to 16.5 g/dl/49% in men and 16 g/dl/48% in women.
Aims
We aimed to apply the proposed WHO 2015 criteria in order to determine whether this contribution in the identification of masked PV would compensate the work overload in our laboratory and clinical practise.
Methods
We selected samples of patients from routine analytical test that meet the new proposed WHO criteria from 22/12/2015 to 23/01/2016 and studied the presence of JAK2V617F mutation as mayor diagnosis criteria for PV. JAK2V617F mutation was determined qualitatively by amplification refractory mutation system polymerase chain reaction assay. We collected white blood count, erytrocytes and platelets levels as well. For statistical analysis has been used ShapiroWilk test to check the normality of the data of quantitative variables. The statistical program used was R Core Team (2014).
Results
In our study, there were 48 patients: 47 men and 1 woman. The median age of the patients was 48,5 years (range: 17 - 73). The median of HB was 17.7 g/dL (16.5 – 18.3) and the median HCT was 51.35% (48.1 – 55.4%). The number of positive JAK2V617F mutation was cero. The rest of analytical characters were: Erythrocytes (average 5.44 10e6/uL, 1.36 - 6.52), leykocytes (average 9.09 10e3/uL, 3.87 - 19.8) and Platelets (average 259.02 10e3/uL, 134 - 416).
Conclusion
Amont the 48 patients, none of them vas positive for JAKV617F mutation.Admission of new criteria would means a high increase in the numbre of patients to be evaluated, implying an enhane human and laboratory resource consumption, with a significant economic impact. Based on our results, we wonder whether these new proposed WHO criteria should be approved.
Session topic: E-poster
Keyword(s): Diagnosis, Polycythemia vera, WHO classification
Type: Publication Only
Background
There are controversies regarding on which cell parameter may be more conveniently used as a surrogate criteria of an increased red cell mass (RCM), that is, hemoglobin (HB) level and hematocrit (HCT) value. According to the 2007/2008 WHO classification, HB level should be >18.5 g/dl in men and >16.5 g/dl in women and/or increased HCT. It has been argued that application of these criteria may result in an underdiagnosis of PV by excluding patients with actual RCM mass that is 25% above mean predicted value, but whose HB and HCT levels are below the WHO guidelines. Therefore, recently the WHO revised the criteria and in 2015 made a new proposal lowering the HB/HCT threshold to 16.5 g/dl/49% in men and 16 g/dl/48% in women.
Aims
We aimed to apply the proposed WHO 2015 criteria in order to determine whether this contribution in the identification of masked PV would compensate the work overload in our laboratory and clinical practise.
Methods
We selected samples of patients from routine analytical test that meet the new proposed WHO criteria from 22/12/2015 to 23/01/2016 and studied the presence of JAK2V617F mutation as mayor diagnosis criteria for PV. JAK2V617F mutation was determined qualitatively by amplification refractory mutation system polymerase chain reaction assay. We collected white blood count, erytrocytes and platelets levels as well. For statistical analysis has been used ShapiroWilk test to check the normality of the data of quantitative variables. The statistical program used was R Core Team (2014).
Results
In our study, there were 48 patients: 47 men and 1 woman. The median age of the patients was 48,5 years (range: 17 - 73). The median of HB was 17.7 g/dL (16.5 – 18.3) and the median HCT was 51.35% (48.1 – 55.4%). The number of positive JAK2V617F mutation was cero. The rest of analytical characters were: Erythrocytes (average 5.44 10e6/uL, 1.36 - 6.52), leykocytes (average 9.09 10e3/uL, 3.87 - 19.8) and Platelets (average 259.02 10e3/uL, 134 - 416).
Conclusion
Amont the 48 patients, none of them vas positive for JAKV617F mutation.Admission of new criteria would means a high increase in the numbre of patients to be evaluated, implying an enhane human and laboratory resource consumption, with a significant economic impact. Based on our results, we wonder whether these new proposed WHO criteria should be approved.
Session topic: E-poster
Keyword(s): Diagnosis, Polycythemia vera, WHO classification
Abstract: PB2029
Type: Publication Only
Background
There are controversies regarding on which cell parameter may be more conveniently used as a surrogate criteria of an increased red cell mass (RCM), that is, hemoglobin (HB) level and hematocrit (HCT) value. According to the 2007/2008 WHO classification, HB level should be >18.5 g/dl in men and >16.5 g/dl in women and/or increased HCT. It has been argued that application of these criteria may result in an underdiagnosis of PV by excluding patients with actual RCM mass that is 25% above mean predicted value, but whose HB and HCT levels are below the WHO guidelines. Therefore, recently the WHO revised the criteria and in 2015 made a new proposal lowering the HB/HCT threshold to 16.5 g/dl/49% in men and 16 g/dl/48% in women.
Aims
We aimed to apply the proposed WHO 2015 criteria in order to determine whether this contribution in the identification of masked PV would compensate the work overload in our laboratory and clinical practise.
Methods
We selected samples of patients from routine analytical test that meet the new proposed WHO criteria from 22/12/2015 to 23/01/2016 and studied the presence of JAK2V617F mutation as mayor diagnosis criteria for PV. JAK2V617F mutation was determined qualitatively by amplification refractory mutation system polymerase chain reaction assay. We collected white blood count, erytrocytes and platelets levels as well. For statistical analysis has been used ShapiroWilk test to check the normality of the data of quantitative variables. The statistical program used was R Core Team (2014).
Results
In our study, there were 48 patients: 47 men and 1 woman. The median age of the patients was 48,5 years (range: 17 - 73). The median of HB was 17.7 g/dL (16.5 – 18.3) and the median HCT was 51.35% (48.1 – 55.4%). The number of positive JAK2V617F mutation was cero. The rest of analytical characters were: Erythrocytes (average 5.44 10e6/uL, 1.36 - 6.52), leykocytes (average 9.09 10e3/uL, 3.87 - 19.8) and Platelets (average 259.02 10e3/uL, 134 - 416).
Conclusion
Amont the 48 patients, none of them vas positive for JAKV617F mutation.Admission of new criteria would means a high increase in the numbre of patients to be evaluated, implying an enhane human and laboratory resource consumption, with a significant economic impact. Based on our results, we wonder whether these new proposed WHO criteria should be approved.
Session topic: E-poster
Keyword(s): Diagnosis, Polycythemia vera, WHO classification
Type: Publication Only
Background
There are controversies regarding on which cell parameter may be more conveniently used as a surrogate criteria of an increased red cell mass (RCM), that is, hemoglobin (HB) level and hematocrit (HCT) value. According to the 2007/2008 WHO classification, HB level should be >18.5 g/dl in men and >16.5 g/dl in women and/or increased HCT. It has been argued that application of these criteria may result in an underdiagnosis of PV by excluding patients with actual RCM mass that is 25% above mean predicted value, but whose HB and HCT levels are below the WHO guidelines. Therefore, recently the WHO revised the criteria and in 2015 made a new proposal lowering the HB/HCT threshold to 16.5 g/dl/49% in men and 16 g/dl/48% in women.
Aims
We aimed to apply the proposed WHO 2015 criteria in order to determine whether this contribution in the identification of masked PV would compensate the work overload in our laboratory and clinical practise.
Methods
We selected samples of patients from routine analytical test that meet the new proposed WHO criteria from 22/12/2015 to 23/01/2016 and studied the presence of JAK2V617F mutation as mayor diagnosis criteria for PV. JAK2V617F mutation was determined qualitatively by amplification refractory mutation system polymerase chain reaction assay. We collected white blood count, erytrocytes and platelets levels as well. For statistical analysis has been used ShapiroWilk test to check the normality of the data of quantitative variables. The statistical program used was R Core Team (2014).
Results
In our study, there were 48 patients: 47 men and 1 woman. The median age of the patients was 48,5 years (range: 17 - 73). The median of HB was 17.7 g/dL (16.5 – 18.3) and the median HCT was 51.35% (48.1 – 55.4%). The number of positive JAK2V617F mutation was cero. The rest of analytical characters were: Erythrocytes (average 5.44 10e6/uL, 1.36 - 6.52), leykocytes (average 9.09 10e3/uL, 3.87 - 19.8) and Platelets (average 259.02 10e3/uL, 134 - 416).
Conclusion
Amont the 48 patients, none of them vas positive for JAKV617F mutation.Admission of new criteria would means a high increase in the numbre of patients to be evaluated, implying an enhane human and laboratory resource consumption, with a significant economic impact. Based on our results, we wonder whether these new proposed WHO criteria should be approved.
Session topic: E-poster
Keyword(s): Diagnosis, Polycythemia vera, WHO classification
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