Should the Panic Values in Clinical Biochemistry Laboratories be Revised According to Criteria in the Diagnosis of Chronic Myeloproliferative Neoplasms?

Abstract

Aim: Panic values are laboratory test results that indicate that the patient may be in a life-threatening condition if urgent action is not taken. Each medical laboratory should determine their panic values and also they have to report and document the results. Chronic myeloproliferative neoplasms (MPN), including malign diseases such as polycythemia vera, essential thrombocythemia, primary myelofibrosis and chronic myeloid leukemia, is a malignant and clonal disease of hematopoietic tissue. In 2016, World Health Organization (WHO) updated the criteria of classification for hematopoietic and lymphoid tissue tumors. The aim of this study is to compare the panic value reports of our laboratory with the number of tests that exceed the limit values for chronic MPNs determined according to the new WHO criteria. Materials and Method: In the study, the results of complete blood count of 58223 patients over the age of 15 were evaluated. Hemoglobin, hematocrit, platelet and leukocyte counts were evaluated and compared according to reported the panic values of our laboratory and the WHO criteria for chronic MPN. Results: When the hemoglobin values are evaluated due to currently used panic values instead of WHO criteria, the necessity of bone marrow examination is overlooked and 1.13% of women and 8.90% of men could not be followed in terms of chronic MPN. Also, the hematocrit values of 9.59 % of women and 8.52% men could not be informative. The hemoglobin values in 0.68% of women and in 1.74% of men; the hematocrit values in 0.94 % of women and in 0.38% of men could not be taken as a warning for chronic MPN without performing marrow examination. For platelet and leukocyte counts the rates are 2.20% and 24.78%, respectively. Conclusion: In order to provide early information in terms of chronic MPN, panic values should be reviewed and rearranged according criteria in the 2016 WHO guideline.