Anna L Godfrey, Nikolaos Sousos, Rebecca Frewin, Mahesh Prahladan, Anna C Green, Andrew McGregor, Alesia Khan, Kate Milne, Faisal Amin, Elena Torre, Emma J Gudgin, Jonathan Lambert, Andrew J Wilson, Daniel Royston, Claire N Harrison, Adam J Mead
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Clinical utility of investigations in triple-negative thrombocytosis: A real-world, multicentre evaluation of UK practice.
Diagnosis of essential thrombocythaemia (ET) is challenging in patients lacking JAK2/CALR/MPL mutations. In a retrospective evaluation of 320 patients with 'triple-negative thrombocytosis', we assessed utility of bone marrow histology (90.9% of patients) and myeloid gene panel (MGP, 55.6%). Supportive histology ('myeloproliferative neoplasm-definite/probable', 36.8%) was associated with higher platelet counts and varied between centres. 14.6% MGP revealed significant variants: 3.4% JAK2/CALR/MPL and 11.2% other myeloid genes. Final clinical diagnosis was strongly predicted by histology, not MGP. 23.7% received cytoreduction (17.6% under 60 years). Real-world 'triple-negative' ET diagnosis currently depends heavily on histology; we advocate caution in MGP-negative cases and that specific guidelines are needed.
期刊介绍:
The British Journal of Haematology publishes original research papers in clinical, laboratory and experimental haematology. The Journal also features annotations, reviews, short reports, images in haematology and Letters to the Editor.