Abstract
Objectives: The World Health Organization (WHO) classification (2008) is widely used to diagnose polycythemia vera (PV). However, some patients clinically suspected of PV may not be definitely diagnosed because they do not have a high hemoglobin (Hb) level, one of the main and essential diagnostic criteria, or because of the lack of or unfilled minor criteria such as bone marrow biopsy, endogenous erythroid colonies, and serum erythropoietin. The British Committee for Standards in Haematology (BCSH) employed hematocrit (Ht), but not Hb, as an indicator in the PV diagnostic guidelines. Furthermore, if the presence of the JAK2 gene mutation is demonstrated, PV can be diagnosed with Ht only by BCSH. Therefore, we evaluated the usefulness of BCSH criteria for diagnosing PV in Japanese patients.
Methods: We determined hematological and clinical differences in 99 patients who met the BCSH criteria (Group A) and 69 PV patients who met the WHO criteria (Group B).
Results: All patients in Group B also met the BCSH criteria. Thirty patients in Group A (43%) did not fulfill the WHO criteria. No significant differences were observed in white blood cell and platelet counts, serum erythropoietin levels, the JAK2V617F allele burden, or the risk of thrombosis and transformation into myelofibrosis between Groups A and B.
Conclusions: PV cases diagnosed by the BCSH criteria showed the same clinical picture as those diagnosed by the WHO criteria. In view of actual clinical settings, the diagnostic criteria of BCSH criteria may be useful for the diagnosis of PV in Japanese patients.
