Myelofibrosis classification: Difference between revisions

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==Classification==
==Classification==
*Myelofibrosis is classified into:
*Myelofibrosis is divided into two types:
:*Primary
:*Primary
:*Secondary
:*Secondary
*The primary type  
===Primary Myelofibrosis===
Based on the origin, myelofibrosis may be classified into two subtypes: '''primary''' and '''secondary'''.<ref name=classmyelof1>Classification of myelofibrosis. Dr Henry Knipe and Dr Yuranga Weerakkody et al. Radiopaedia 2016. http://radiopaedia.org/articles/myelofibrosis. Accessed on March 14, 2016</ref>
*The primary type, characterized by stem cell-derived clonal myeloproliferation, is often associated with mutations of the thrombopoietin receptor gene (MPL), the calreticulin (CALR) gene, or Janus kinase 2 (JAK2) gene with 90% of the patients carrying one of these mutations and the rest 10% are categorized as "triple-negative".<ref name="pmid27870387">{{cite journal |vauthors=Tefferi A |title=Primary myelofibrosis: 2017 update on diagnosis, risk-stratification, and management |journal=Am. J. Hematol. |volume=91 |issue=12 |pages=1262–1271 |date=December 2016 |pmid=27870387 |doi=10.1002/ajh.24592 |url=}}</ref><ref name="pmid29426921">{{cite journal |vauthors=Barbui T, Thiele J, Gisslinger H, Kvasnicka HM, Vannucchi AM, Guglielmelli P, Orazi A, Tefferi A |title=The 2016 WHO classification and diagnostic criteria for myeloproliferative neoplasms: document summary and in-depth discussion |journal=Blood Cancer J |volume=8 |issue=2 |pages=15 |date=February 2018 |pmid=29426921 |pmc=5807384 |doi=10.1038/s41408-018-0054-y |url=}}</ref>
*Primary myelofibrosis indicates that the disease is of unknown or spontaneous origin.
*The 2016 World Health Organization (WHO) revised classification of myeloproliferative neoplasms (MPNs) defines 2 stages of primary myelofibrosis (PMF):
*Secondary myelofibrosis develops secondary to [[polycythemia vera]], [[essential thrombocythaemia]], [[leukemia]], or [[lymphoma]].
:*Prefibrotic/early (pre-primary myelofibrosis) phase<ref name="pmid28351937">{{cite journal |vauthors=Guglielmelli P, Pacilli A, Rotunno G, Rumi E, Rosti V, Delaini F, Maffioli M, Fanelli T, Pancrazzi A, Pietra D, Salmoiraghi S, Mannarelli C, Franci A, Paoli C, Rambaldi A, Passamonti F, Barosi G, Barbui T, Cazzola M, Vannucchi AM |title=Presentation and outcome of patients with 2016 WHO diagnosis of prefibrotic and overt primary myelofibrosis |journal=Blood |volume=129 |issue=24 |pages=3227–3236 |date=June 2017 |pmid=28351937 |doi=10.1182/blood-2017-01-761999 |url=}}</ref>
:*Overtly fibrotic (overt primary myelofibrosis) phase
===Secondary Myelofibrosis===
*Myelofibrosis can be secondary to mulpltiple primary conditons such as:
:*Malignancies and hematologic disorders (Hodgkin lymphoma, non-Hodgkin lymphoma, essential thrombocythemia, polycythemia vera, multiple myeloma, and malignancies with metastases to the bone)
:* Toxins (Benzene, thorium dioxide, and x- or γ-radiation)
:*Infections (Osteomyelitis, tuberculosis [TB])
:*Autoimmune diseases (systemic lupus erythematosus [SLE], multiple sclerosis [MS])


==References==
==References==

Revision as of 22:45, 8 November 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2], Sujit Routray, M.D. [3]

Overview

Myelofibrosis is subclassified into primary and secondary types with the primary type being the more common and a high proportion of the cases resulting from mutations in the Janus kinase 2 (JAK2) gene. It can be secondary to a variety of malignant, non-malignant, and hematologic conditions. It can also be secondary to infections, toxins, and autoimmune diseases.

Classification

  • Myelofibrosis is divided into two types:
  • Primary
  • Secondary

Primary Myelofibrosis

  • The primary type, characterized by stem cell-derived clonal myeloproliferation, is often associated with mutations of the thrombopoietin receptor gene (MPL), the calreticulin (CALR) gene, or Janus kinase 2 (JAK2) gene with 90% of the patients carrying one of these mutations and the rest 10% are categorized as "triple-negative".[1][2]
  • The 2016 World Health Organization (WHO) revised classification of myeloproliferative neoplasms (MPNs) defines 2 stages of primary myelofibrosis (PMF):
  • Prefibrotic/early (pre-primary myelofibrosis) phase[3]
  • Overtly fibrotic (overt primary myelofibrosis) phase

Secondary Myelofibrosis

  • Myelofibrosis can be secondary to mulpltiple primary conditons such as:
  • Malignancies and hematologic disorders (Hodgkin lymphoma, non-Hodgkin lymphoma, essential thrombocythemia, polycythemia vera, multiple myeloma, and malignancies with metastases to the bone)
  • Toxins (Benzene, thorium dioxide, and x- or γ-radiation)
  • Infections (Osteomyelitis, tuberculosis [TB])
  • Autoimmune diseases (systemic lupus erythematosus [SLE], multiple sclerosis [MS])

References

  1. Tefferi A (December 2016). "Primary myelofibrosis: 2017 update on diagnosis, risk-stratification, and management". Am. J. Hematol. 91 (12): 1262–1271. doi:10.1002/ajh.24592. PMID 27870387.
  2. Barbui T, Thiele J, Gisslinger H, Kvasnicka HM, Vannucchi AM, Guglielmelli P, Orazi A, Tefferi A (February 2018). "The 2016 WHO classification and diagnostic criteria for myeloproliferative neoplasms: document summary and in-depth discussion". Blood Cancer J. 8 (2): 15. doi:10.1038/s41408-018-0054-y. PMC 5807384. PMID 29426921.
  3. Guglielmelli P, Pacilli A, Rotunno G, Rumi E, Rosti V, Delaini F, Maffioli M, Fanelli T, Pancrazzi A, Pietra D, Salmoiraghi S, Mannarelli C, Franci A, Paoli C, Rambaldi A, Passamonti F, Barosi G, Barbui T, Cazzola M, Vannucchi AM (June 2017). "Presentation and outcome of patients with 2016 WHO diagnosis of prefibrotic and overt primary myelofibrosis". Blood. 129 (24): 3227–3236. doi:10.1182/blood-2017-01-761999. PMID 28351937.

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