Abnormal Megakryocyte

[Stoosh]

hi Hunter

I searched for the meaning of abnormal megakaryocyte and found the following from ChatGPT.

I am reproducing it here.

“An **abnormal megakaryocyte** refers to a megakaryocyte that displays atypical characteristics in size, shape, or function. Megakaryocytes are large cells in the bone marrow responsible for producing platelets, which are essential for blood clotting. Normally, megakaryocytes undergo a process called endomitosis, where their nuclei divide without cell division, leading to their large size. These cells eventually release platelets into the bloodstream.

When megakaryocytes are **abnormal**, it can signal certain underlying conditions, such as:

1. **Myeloproliferative disorders**: In diseases like **essential thrombocythemia** or **polycythemia vera**, megakaryocytes may be larger than normal, show abnormal nuclear shapes, or appear in excessive numbers. These conditions result in overproduction of platelets, sometimes leading to large or immature platelets in circulation.

2. **Myelodysplastic syndromes (MDS)**: These disorders affect the bone marrow’s ability to produce normal blood cells, including megakaryocytes. Abnormal megakaryocytes in MDS may appear smaller, have irregularly shaped nuclei, or fail to produce functional platelets properly.

3. **Reactive changes**: In response to infection, inflammation, or certain medications, megakaryocytes might become larger or more numerous temporarily as the body tries to compensate for platelet loss or dysfunction.

Abnormal megakaryocytes are often detected during a bone marrow biopsy, which helps to determine the underlying cause. The presence of abnormal megakaryocytes usually prompts further investigation into potential bone marrow disorders or other hematological conditions.”

Hence, it can be due to any of the above including adjustment due to treatment . Also I learnt earlier that if the count is high the laboratory may not give significance to larger platelets when they report higher counts . But when they report within range count they emphasise size. .

In other words since I had mild thrombocytosis and Jack2 positive reflecting PV they might not have reported the size earlier. ( ie with out of range higher platelets the lab might not report size of platelets even they were higher).

Any way I will discuss with haematologist in next consultation.

It is important to know that , because of to know the future progression of the disorder and its effects if any exists and to discuss of possible treatments if different

Thanks again for raising it .

[hunter5582]

That looks like a pretty good summary regarding megakaryocytes. The abnormalities in megakaryocytes are found with both PV and ET.

Diagnostic criteria for ET includes BM biopsy showing proliferation mainly of the megakaryocyte lineage with increased numbers of enlarged, mature megakaryocytes with hyperlobulated nuclei. Diagnostic criteria for PV includes BM biopsy showing hypercellularity for age with trilineage growth (panmyelosis) including prominent erythroid, granulocytic and megakaryocytic proliferation with pleomorphic, mature megakaryocytes (differences in size).

I would not be surprised if the large platelet size is not a new finding. just one that was not previously reported. Best to check with your hematologist as you plan to do. Asking about the possibility of progression also makes sense, though I do not think that is necessarily when this finding means. It does make sense to discuss preventing progression as a PV treatment goal. Disease modification is a valid treatment goal for any MPN. It certainly affects your treatment decisions.

Wishing you all the best.