Assessment of megakaryocytes’ size and morphology in selected myeloproliferative neoplasms

Abstract

<br><b>Introduction:</b> Contemporary technological development make the cytological analysis of megakaryocytes (MKs) a valuable tool for supporting differential diagnosis of myeloproliferative neoplasms’ (MPNs) early stages.</br> <br><b>Aim:</b> The aim of the study was to identify megakaryocyte’s cytological differences between chronic myelogenous leukemia (CML), polycythemia vera (PV) and essential thrombocythemia (ET), as well as to assess the usefulness of this analysis in differential diagnosis of the aforementioned MPNs.</br> <br><b>Materials and methods:</b> Bone marrow aspirate smears were obtained from 20 patients with CML, 15 patients with PV and 12 patients with ET. The control included bone marrow biopsies from 15 patients without any hematological disorder. The following megakaryocyte’s parameters were examined: cell diameter, cytoplasmic area, nuclear area, nuclear-cytoplasmic ratio and nuclear lobulation.</br> <br><b>Results:</b> Cytological analysis revealed a significantly decreased megakaryocytes’ size and the prevalence of cells with hypolobulated nuclei in CML patients comparing to other groups. MKs in ET were found to have characteristic staghorn-like hyperlobulated nucleus, whereas polycythemia vera showed the predominance of cells with multilobulated nuclei (4-7 lobes) and a tendency to hyperlobulation. However, there were no significant differences in mean values for cytoplasmic and nuclear area among these two groups of patients.</br> <br><b>Conclusion:</b> Characteristic megakaryocytes’ cytological differences in CML patients may be useful in differential diagnosis of the CML’s early stage. MKs’ size and nuclear-cytoplasmic ratio are not useful in differentiation between polycythemia vera and essential thrombocythemia.</br>