Clinical utility of investigations in triple‐negative thrombocytosis: A real‐world, multicentre evaluation of <scp>UK</scp> practice-Reference-Cited by-同舟云学术

Clinical utility of investigations in triple‐negative thrombocytosis: A real‐world, multicentre evaluation of UK practice

Published:2024-07-14 Issue: Volume: Page:
ISSN:0007-1048
Container-title:British Journal of Haematology
language:en
Short-container-title:Br J Haematol

Author:

Godfrey Anna L.¹^ORCID,Sousos Nikolaos²³^ORCID,Frewin Rebecca⁴,Prahladan Mahesh¹,Green Anna C.⁵,McGregor Andrew⁶,Khan Alesia⁷^ORCID,Milne Kate¹,Amin Faisal⁸,Torre Elena⁸⁹,Gudgin Emma J.¹,Lambert Jonathan¹⁰,Wilson Andrew J.¹⁰^ORCID,Royston Daniel¹¹^ORCID,Harrison Claire N.⁸^ORCID,Mead Adam J.²³^ORCID

Affiliation:

1. Department of Haematology Cambridge University Hospitals NHS Foundation Trust Cambridge UK

2. NIHR Biomedical Research Centre and MRC Molecular Haematology Unit Weatherall Institute of Molecular Medicine, University of Oxford Oxford UK

3. Department of Haematology Oxford University Hospitals NHS Foundation Trust Oxford UK

4. Department of Haematology Gloucestershire Hospitals NHS Foundation Trust Gloucester UK

5. Department of Histopathology Guy's and St Thomas' NHS Foundation Trust London UK

6. Department of Haematology Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne UK

7. Department of Haematology Leeds Teaching Hospitals NHS Trust Leeds UK

8. Department of Haematology Guy's and St Thomas' NHS Foundation Trust London UK

9. Comprehensive Cancer Centre King's College London London UK

10. Department of Haematology University College London Hospitals NHS Foundation Trust London UK

11. Department of Histopathology Oxford University Hospitals NHS Foundation Trust Oxford UK

Abstract

SummaryDiagnosis of essential thrombocythaemia (ET) is challenging in patients lacking JAK2/CALR/MPL mutations. In a retrospective evaluation of 320 patients with ‘triple‐negative thrombocytosis’, we assessed utility of bone marrow histology (90.9% of patients) and myeloid gene panel (MGP, 55.6%). Supportive histology (‘myeloproliferative neoplasm‐definite/probable’, 36.8%) was associated with higher platelet counts and varied between centres. 14.6% MGP revealed significant variants: 3.4% JAK2/CALR/MPL and 11.2% other myeloid genes. Final clinical diagnosis was strongly predicted by histology, not MGP. 23.7% received cytoreduction (17.6% under 60 years). Real‐world ‘triple‐negative’ ET diagnosis currently depends heavily on histology; we advocate caution in MGP‐negative cases and that specific guidelines are needed.

Funder

National Institute for Health and Care Research

Publisher

Wiley

Link

https://onlinelibrary.wiley.com/doi/pdf/10.1111/bjh.19643

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