Polycythemia vera laboratory tests
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2] Shyam Patel [3]
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Overview
Laboratory findings associated with the diagnosis of polycythemia vera include erythrocytosis, leukocytosis, and thrombocytosis.[1]
Laboratory Findings
Laboratory findings associated with polycythemia vera include:[1][2][3][4][5][6][7]
- Erythrocytosis: This is a hallmark laboratory finding in polycythemia vera.
- Increased hemoglobin: Hemoglobin is usually more than 16.5 g/dl. Elevated hemoglobin corresponds with elevated red blood cell mass.
- Increased granulocytes of all types: Polycythemia vera is characterized by panmyelosis (elevation of cell counts of all 3 cell lines).
- Increased basophils and eosinophils
- Thrombocytosis: This is an elevation of platelet count to more than 400,000/mcl.
- Leukocytosis: This is an elevation of white blood cell count to more than 11,000/mcl.
- Blood chemistry
- The following blood levels may be elevated (but these are non-specific):
- Blood urea nitrogen (BUN)
- Creatinine
- Phosphate
- Lactate dehydrogenase (LDH)
- Alanine aminotransferase (ALT)
- Aspartate transaminase (AST)
- Uric acid
- Bleeding and clotting factor
- The following blood levels may be elevated:
- Prothrombin time (PT) or international normalized ratio (INR)
- Partial thromboplastin time (PTT)
- Flow cytometry: Flow cytometry of the peripheral blood is usually normal in polycythemia vera. There is usually no abnormal immunophenotype.
- Cytogenetics: Cytogenetics are usually normal in patients with polycythemia vera.
- Fluorescent in situ hybridization (FISH): FISH is usually normal in polycythemia vera. There are no particular translocations, deletions, insertions, or duplications.
- Erythropoietin (EPO): Erythropoietin is usually low in polycythemia vera. Low erythropoietin is a minor diagnostic criteria for polycythemia vera in the 2016 WHO classification of myeloproliferative neoplasms. In contrast, erythropoietin is usually high in secondary polycythemia.[8]
References
- ↑ 1.0 1.1 Canadian Cancer Society.2015.http://www.cancer.ca/en/cancer-information/cancer-type/leukemia/leukemia/polycythemia-vera/?region=ab
- ↑ Hawley JM, Owen LJ, MacKenzie F, Mussell C, Cowen S, Keevil BG (2015). "Candidate Reference Measurement Procedure for the Quantification of Total Serum Cortisol with LC-MS/MS". Clin Chem. doi:10.1373/clinchem.2015.243576. PMID 26534968.
- ↑ Amiel A, Gaber E, Manor Y, Fejgin M, Joseph-Lerner N, Ravid M; et al. (1995). "Fluorescence in situ hybridization for the detection of trisomies 8 and 9 in polycythemia vera". Cancer Genet Cytogenet. 79 (2): 153–6. PMID 7889510.
- ↑ Mazzotta S, Guerranti R, Gozzetti A, Bucalossi A, Bocchia M, Sammassimo S; et al. (2006). "Increased serum lactate dehydrogenase isoenzymes in Ph-negative chronic myeloproliferative diseases: a metabolic adaptation?". Hematology. 11 (4): 239–44. doi:10.1080/10245330600774835. PMID 17178662.
- ↑ Denman M, Szur L, Ansell BM (1966). "Hyperuricaemia in polycythaemia vera". Ann Rheum Dis. 25 (4): 340–4. PMC 2453349. PMID 5947579.
- ↑ Murakami J, Shimizu Y (2013). "Hepatic manifestations in hematological disorders". Int J Hepatol. 2013: 484903. doi:10.1155/2013/484903. PMC 3626309. PMID 23606974.
- ↑ Remacha AF, Montserrat I, Santamaria A, Oliver A, Barceló MJ, Parellada M (1997). "Serum erythropoietin in the diagnosis of polycythemia vera. A follow-up study". Haematologica. 82 (4): 406–10. PMID 9299851.
- ↑ Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM; et al. (2016). "The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia". Blood. 127 (20): 2391–405. doi:10.1182/blood-2016-03-643544. PMID 27069254.