Myeloproliferative neoplasm overview
|
Myeloproliferative Neoplasm Microchapters |
|
Differentiating myeloproliferative neoplasm from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Myeloproliferative neoplasm overview On the Web |
|
American Roentgen Ray Society Images of Myeloproliferative neoplasm overview |
|
Directions to Hospitals Treating Myeloproliferative neoplasm |
|
Risk calculators and risk factors for Myeloproliferative neoplasm overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2]
Overview
The myeloproliferative neoplasm are a group of diseases of the bone marrow in which excess cells are produced. Myeloproliferative neoplasm may be classified according to the World Health Organization into eight subtypes (chronic myelogenous leukemia, BCR-ABL1–positive, chronic neutrophilic leukemia, polycythemia vera, primary myelofibrosis, essential thrombocythemia, chronic eosinophilic leukemia, not otherwise specified, mastocytosis, myeloproliferative neoplasms, unclassifiable).[1][2] They are related to, and may evolve into, myelodysplastic syndrome and acute myeloid leukemia, although the myeloproliferative diseases on the whole have a much better prognosis than these conditions. Clinical and pathologic features in the myeloproliferative neoplasms are due to dysregulated proliferation and expansion of myeloid progenitors in the bone marrow, resulting in altered populations of granulocytes, erythrocytes, or platelets in the peripheral blood. Myeloproliferative neoplasm is caused by a mutation in the BCR-ABL, Janus kinase 2, and calreticulin genes.[3][4] Patients may be asymptomatic at diagnosis. However, if symptoms present, symptoms of myeloproliferative neoplasm include fever, fatigue, and bleeding.[5][6] The mainstay of therapy for myeloproliferative neoplasm is chemotherapy, aspirin, and palliative care.[7][8]
Historical Perspective
Myeloproliferative neoplasm was first discovered by William Dameshek, an American hematologist, in 1951.[9]
Classification
Myeloproliferative neoplasm may be classified according to the World Health Organization into eight subtypes: chronic myelogenous leukemia, chronic neutrophilic leukemia, polycythemia vera, primary myelofibrosis, essential thrombocythemia, chronic eosinophilic leukemia, mastocytosis, and myeloproliferative neoplasms, unclassifiable.[1]
Pathophysiology
Clinical and pathologic features in the myeloproliferative neoplasms are due to dysregulated proliferation and expansion of myeloid progenitors in the bone marrow, resulting in altered populations of granulocytes, erythrocytes, or platelets in the peripheral blood.
Causes
Myeloproliferative neoplasm is caused by a mutation in the BCR-ABL, Janus kinase 2, and calreticulin genes.[3][4][3]
Differentiating Myeloproliferative neoplasm from other Diseases
Myeloproliferative neoplasm must be differentiated from acute lymphoblastic leukemia, acute myelogenous leukemia, chronic myelogenous leukemia, essential thrombocytosis, hypereosinophilic syndrome, non-Hodgkin lymphoma, primary myelofibrosis, secondary thrombocytosis, splenomegaly, systemic mastocytosis, and waldenstrom macroglobulinemia.
Epidemiology and Demographics
The incidence of myeloproliferative neoplasm is approximately 7.8 per 100,000 individuals worldwide.[10]
Risk factors
There are no established risk factors for myeloproliferative neoplasm.
Screening
Screening for myeloproliferative neoplasm by quantitative cell-based JAK2V617F mutation assays may be helpful among patients with erythrocytosis, thrombocytosis, splanchnic vein thrombosis, and unexplained BCR-ABL negative granulocytosis.[11]
Natural History, Complications and Prognosis
If left untreated, patients with myeloproliferative neoplasm may progress to develop weight loss, fever, and night sweats. Common complications of myeloproliferative neoplasm include splenomegaly, bleeding, and thrombosis. Prognosis is generally good with treatment, and the 3-year survival rate of patients with myeloproliferative neoplasm is approximately 35%.[12][5]
Diagnosis
Staging
References
- ↑ 1.0 1.1 Vardiman JW, Thiele J, Arber DA, Brunning RD, Borowitz MJ, Porwit A; et al. (2009). "The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes". Blood. 114 (5): 937–51. doi:10.1182/blood-2009-03-209262. PMID 19357394.
- ↑ Valent P, Horny HP, Escribano L, Longley BJ, Li CY, Schwartz LB; et al. (2001). "Diagnostic criteria and classification of mastocytosis: a consensus proposal". Leuk Res. 25 (7): 603–25. PMID 11377686.
- ↑ 3.0 3.1 3.2 Ganfyd. Polycythaemia vera 2015.http://www.ganfyd.org/index.php?title=Polycythemia_vera
- ↑ 4.0 4.1 Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID http://dx.doi.org/10.1182/blood-2013-11-538983 Check
|pmid=value (help). - ↑ 5.0 5.1 Agarwal MB, Malhotra H, Chakrabarti P, Varma N, Mathews V, Bhattacharyya J; et al. (2015). "Myeloproliferative neoplasms working group consensus recommendations for diagnosis and management of primary myelofibrosis, polycythemia vera, and essential thrombocythemia". Indian J Med Paediatr Oncol. 36 (1): 3–16. doi:10.4103/0971-5851.151770. PMC 4363847. PMID 25810569.
- ↑ Canadian Cancer Society.2015.http://www.cancer.ca/en/cancer-information/cancer-type/leukemia-chronic-myelogenous-cml/signs-and-symptoms/?region=ab
- ↑ National Cancer Institute. Physician Data Query Database 2015.http://www.cancer.gov/types/leukemia/hp/cml-treatment-pdq#section/_19
- ↑ A. Schmoldt, H. F. Benthe & G. Haberland (1975). "Digitoxin metabolism by rat liver microsomes". Biochemical pharmacology. 24 (17): 1639–1641. PMID 10. Unknown parameter
|month=ignored (help) - ↑ Dameshek W (1951). "Some speculations on the myeloproliferative syndromes". Blood. 6 (4): 372–5. PMID 14820991.
- ↑ Centers for Disease Control and Prevention. WTC Health Program.Myeloid Malignancieshttp://www.cdc.gov/wtc/pdfs/WTCHP_PP_MyeloidMalignancies_02012014.pdf
- ↑ Tefferi A, Noel P, Hanson CA (2011). "Uses and abuses of JAK2 and MPL mutation tests in myeloproliferative neoplasms a paper from the 2010 William Beaumont hospital symposium on molecular pathology". J Mol Diagn. 13 (5): 461–6. doi:10.1016/j.jmoldx.2011.05.007. PMC 3157620. PMID 21723416.
- ↑ Ma X, Does M, Raza A, Mayne ST (2007). "Myelodysplastic syndromes: incidence and survival in the United States". Cancer. 109 (8): 1536–42. doi:10.1002/cncr.22570. PMID 17345612.