inconclusive results for PV

[Lababba]

𝗜𝗻𝗰𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝘃𝗲 𝗳𝗶𝗻𝗱𝗶𝗻𝗴𝘀

The bone marrow biopsy results indicate an expanded erythropoiesis and relatively reduced myelopoiesis. There are no clear abnormalities in megakaryopoiesis or an increase in myeloblasts, and the marrow is not notably cell-rich. Therefore, there are no definite indications of myeloproliferative neoplasia (MPN). The changes are primarily interpreted as reactive/secondary.

However, this interpretation was made with incorrect information stating that jak2 was negative; it is uncertain, meaning they have found a jak2 mutation. Combined with persistent HB above 18, hematocrit up to 54%, and EPO below normal values, it sounds to me like PV. What are your thoughts? It has also been investigated for secondary polycythemia with no findings. Age 37.

Dont get me wrong, the best would, of course, be that there was nothing. But when symptoms like red skin, high blood pressure, fatigue, tingling legs, gout, and blurred vision are present. In addition to most people with the JAK2 mutation having MPN, and both HB, Hematocrit, and EPO indicate MPN, I can't settle for that.

Anyone had results like this?

[hunter5582]

The criteria for PV are to be positive for all three major Criteria or two major and the one Minor Criteria.

Major criteria

1. Hemoglobin > 16.5 g/dL(men) Hemoglobin > 16.0 g/dL (women) or hematocrit > 49% (men) Hematocrit > 48% (women) or increased red cell mass (RCM)c

2. BM biopsy showing hypercellularity for age with trilineage growth (panmyelosis) including prominent erythroid, granulocytic and megakaryocytic proliferation with pleomorphic, mature megakaryocytes (differences in size)

3. Presence of JAK2 or JAK2 exon 12 mutation

Minor Criteria

1. Subnormal serum erythropoietin level

If you have elevated HCT/HGB/RCM, JAK2 positive and low EPO - that meet the diagnostic criteria for PV even in the absence of the bone marrow criteria. Suggest reviewing you findings with a MPN Specialist for the most accurate interpretation. mpnforum.com/tsr-the-list/

[monarch5000]

What are your RBC, Platelet, WBC, RDW and MCV counts? What was the Jak2 allele burden percentage? What Country? I agree the low EPO is strongly suggestive of primary PV.

[gdpone in reply to monarch5000]

I’m very curious to know his response too. As I am awaiting my BMB results and hope for the same as his. So far I meet only two major criteria but not the minor. As my EPO was 8. But I’m also jak2 exon 12 pos.