A Clinician’s Guide to MPN Diagnosis in 2016
– Dr. Hubert Tsui
Revisions to the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia were recently published. These emphasise a synoptic approach to disease entities incorporating clinical information, morphology, immunophenotype, cytogenetics and molecular data. Within the myeloproliferative neoplasms (MPNs) section, changes were made to chronic neutrophilic leukemia (CNL) and the classical MPNs: polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF).
In the Canadian landscape, routine access to molecular testing remains a work in progress (includes some driver mutations e.g. JAK-2 exon 12, MPL, etc.). Additionally, the MPN morphology can be challenging in real-world conditions. Moving forward, there may be an opportunity for intervention with educational programs and quality improvement initiatives.