Polycythemia Vera: New Diagnostic Concept and Its Types

Polycythemia vera (PV) is a clonal Ph-negative myeloproliferative disorder characterized by excessive myeloid proliferation of three hematopoietic cell lineages leading to ineffective myelopoiesis. According to WHO classification (2008), hemoglobin and hematocrit values are listed among the major di...

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Main Authors: AM Kovrigina, VV Baikov
Format: Article
Language:Russian
Published: Practical Medicine Publishing House 2016-04-01
Series:Клиническая онкогематология
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Online Access:http://bloodjournal.ru/en/polycythemia-vera-new-diagnostic-concept-and-its-types/
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author AM Kovrigina
VV Baikov
author_facet AM Kovrigina
VV Baikov
author_sort AM Kovrigina
collection DOAJ
description Polycythemia vera (PV) is a clonal Ph-negative myeloproliferative disorder characterized by excessive myeloid proliferation of three hematopoietic cell lineages leading to ineffective myelopoiesis. According to WHO classification (2008), hemoglobin and hematocrit values are listed among the major diagnostic criteria. However, in many PV patients the levels may be below the diagnostic level, thus leading to underdiagnosis of PV. At present, three clinical types of the disease are recognized: 1) masked (latent/prodromal), 2) classic (overt), and 3) PV with progression/transformation into myelofibrosis. The masked form is most difficult for diagnosis, being highly heterogeneous with regard to clinical manifestations, laboratory data, medical history, and the course of the disease. It includes early stages, some of them with very high platelet count, imitating essential thrombocythemia, cases with abdominal thrombosis, and latent PV. Bone marrow trephine biopsy appears to be the most reliable method for diagnosis of masked PV. Findings typical for PV are readily visible, including hypercellular bone marrow with three-lineage myeloid proliferation, excess of megakaryocytes with mild to moderate cellular atypia and polymorphism. Gradi ng of reticulin fibrosis has impact on prognosis and reflects the risk of progression into myelofibrosis. In revised edition of WHO classification (2016), the typical bone marrow histopathology will be included among the major criteria for the diagnosis of PV, meaning that bone marrow trephine biopsy
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spelling doaj-art-0306afd9cb644a2fb600e672925643e72025-08-20T03:55:32ZrusPractical Medicine Publishing HouseКлиническая онкогематология1997-69332500-21392016-04-019211512210.21320/2500-2139-2016-9-2-115-122Polycythemia Vera: New Diagnostic Concept and Its TypesAM Kovrigina0VV Baikov1Hematology Research Center, 4а Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167R.M. Gorbacheva Scientific Research Institute of Pediatric Hematology and Transplantation; Academician I.P. Pavlov First St. Petersburg State Medical University, 12 Rentgena str., Saint Petersburg, Russian Federation, 197022Polycythemia vera (PV) is a clonal Ph-negative myeloproliferative disorder characterized by excessive myeloid proliferation of three hematopoietic cell lineages leading to ineffective myelopoiesis. According to WHO classification (2008), hemoglobin and hematocrit values are listed among the major diagnostic criteria. However, in many PV patients the levels may be below the diagnostic level, thus leading to underdiagnosis of PV. At present, three clinical types of the disease are recognized: 1) masked (latent/prodromal), 2) classic (overt), and 3) PV with progression/transformation into myelofibrosis. The masked form is most difficult for diagnosis, being highly heterogeneous with regard to clinical manifestations, laboratory data, medical history, and the course of the disease. It includes early stages, some of them with very high platelet count, imitating essential thrombocythemia, cases with abdominal thrombosis, and latent PV. Bone marrow trephine biopsy appears to be the most reliable method for diagnosis of masked PV. Findings typical for PV are readily visible, including hypercellular bone marrow with three-lineage myeloid proliferation, excess of megakaryocytes with mild to moderate cellular atypia and polymorphism. Gradi ng of reticulin fibrosis has impact on prognosis and reflects the risk of progression into myelofibrosis. In revised edition of WHO classification (2016), the typical bone marrow histopathology will be included among the major criteria for the diagnosis of PV, meaning that bone marrow trephine biopsyhttp://bloodjournal.ru/en/polycythemia-vera-new-diagnostic-concept-and-its-types/polycythemia veramyeloproliferative disorderdiagnosis of polycythemia veratypes of polycythemia vera
spellingShingle AM Kovrigina
VV Baikov
Polycythemia Vera: New Diagnostic Concept and Its Types
Клиническая онкогематология
polycythemia vera
myeloproliferative disorder
diagnosis of polycythemia vera
types of polycythemia vera
title Polycythemia Vera: New Diagnostic Concept and Its Types
title_full Polycythemia Vera: New Diagnostic Concept and Its Types
title_fullStr Polycythemia Vera: New Diagnostic Concept and Its Types
title_full_unstemmed Polycythemia Vera: New Diagnostic Concept and Its Types
title_short Polycythemia Vera: New Diagnostic Concept and Its Types
title_sort polycythemia vera new diagnostic concept and its types
topic polycythemia vera
myeloproliferative disorder
diagnosis of polycythemia vera
types of polycythemia vera
url http://bloodjournal.ru/en/polycythemia-vera-new-diagnostic-concept-and-its-types/
work_keys_str_mv AT amkovrigina polycythemiaveranewdiagnosticconceptanditstypes
AT vvbaikov polycythemiaveranewdiagnosticconceptanditstypes