Essential thrombocytosis laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
ET is a diagnosis of exclusion
Diagnostic criteria
The diagnosis of essential thrombocytosis requires the presence of a persistent thrombocytosis of greater than 600 x109/L in the absence of an alternative cause.
The following revised diagnostic criteria for essential thrombocytosis were proposed in 2005 [1]. The diagnosis requires the presence of both A criteria together with B3 to B6, or of criterion A1 together with B1 to B6.
- A1. Platelet count > 600 x 109/L for at least 2 months
- A2. Acquired V617F JAK2 mutation present
- B1. No cause for a reactive thrombocytosis
- normal inflammatory indices
- B2. No evidence of iron deficiency
- stainable iron in the bone marrow or normal red cell mean corpuscular volume
- B3. No evidence of polycythemia vera
- hematocrit < midpoint of normal range or normal red cell mass in presence of normal iron stores
- B4. No evidence of chronic myeloid leukemia
But the Philadelphia chromosome may be present in up to 10% of cases. Patients withe the Philadelphia chromosome have a potential for the development of acute leukemia, especially acute lymphocytic leukemia.
- B5. No evidence of myelofibrosis
- no collagen fibrosis and ≤ grade 2 reticulin fibrosis (using 0–4 scale)
- B6. No evidence of a myelodysplastic syndrome
- no significant dysplasia
- no cytogenetic abnormalities suggestive of myelodysplasia
References
- ↑ Campbell PJ, Green AR. Management of Polycythemia Vera and Essential Thrombocythemia. Hematology (Am Soc Hematol Educ Program). 2005;:201-8. PMID 16304381