How Does 2016 WHO Criteria for Polycythemia Vera Contribute to Our Daily Practice? A Single-Center Study from Turkey

Rafet Eren; Bahar   Funda Sevinçoğlu; Esma  Evrim Doğan; Demet  Aydın; Nihan   Nizam; Naciye   Demirel

doi:10.18502/ijhoscr.v14i4.4478

Rafet Eren
Bahar Funda Sevinçoğlu
Esma Evrim Doğan
Demet Aydın
Nihan Nizam
Naciye Demirel

DOI: https://doi.org/10.18502/ijhoscr.v14i4.4478

Keywords: Polycythemia vera, JAK2V617F mutation, Serum erythropoietin, WHO 2016 revision

Abstract

Background: We evaluated the frequency of subnormal erythropoietin levels, JAK2V617F positivity and polycythemia vera (PV) in patients who did not meet WHO 2008 criterion for hemoglobin levels but were suggested to be investigated for PV in 2016 revision.

Materials and Methods: We assessed the data of 92 patients, who were further evaluated with JAK2V617F mutation and serum erythropoietin (EPO) levels and bone marrow biopsy, if necessary. We also compared this patient group with 20 patients whose Hgb>18.5 g/dL for men and >16.5 g/dL for women.

Results: Nine patients (45%) in the higher hemoglobin group were JAK2V617F positive, while 4 patients (4.3%) in the lower hemoglobin group were JAK2V617F positive (p<0.001). The number of patients with serum EPO levels <4.3 mIU/mL was significantly higher in the higher hemoglobin group (n=13, 65%) than the lower hemoglobin group (n=7, 7.6%) (p<0.001). Finally, the number of patients who received a diagnosis of PV was significantly higher in the higher hemoglobin group (n=13, 65%) than the lower hemoglobin group (n=9, 9.8%) (p<0.001).

Conclusion: We found a substantial increase in patients who were candidates for testing for PV with the introduction of WHO 2016 criteria; these patients were diagnosed with PV with a rate (9.8%) that cannot be underestimated.