The Classic Myeloproliferative Neoplasms

MPL Exon 10 Sequencing: When to Use

October 2011

MPL exon 10 sequencing is primarily useful in those borderline bone marrow cases in which the morphology cannot confidently distinguish between a benign and a myeloproliferative diagnosis. For example, a bone marrow where there is a question of a possible essential thrombocythemia. Frequently, these are cases with thrombocytosis, but without megakaryocyte clusters or only slight megakaryocyte atypia. A second common scenario, is it a possible primary myelofibrosis? The marrow may appear slightly fibrotic but without any megakaryocyte clusters and, again, at best, only slight megakaryocyte atypia. Another possible situation where MPL exon 10 sequencing studies may be useful in peripheral blood studies is if a bone marrow procedure is not feasible–but realizing that this is a low return assay in this situation.

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Exon 10 Sequencing: When to Use

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• Introduction
• Optimizing Laboratory Testing for Hematologic Disorders Series
• Goals for Today's Presentation
• Example of a Recent MPN Referral
• Why Do We Have Test Utilization Issues?
• Why Do We Have Test Utilization Issues?
• So What Should We Do?
• WHO Classification
• Important Laboratory Assays in the MPNs
• JAK2 V617F Background
• JAK2 V617F Background
• Question #1 — JAK2 V617F
• JAK2 V617F
• JAK2 V617F at Mayo Clinic
• Conclusion #1 — JAK2 V617F
• JAK2 Exon 12 Sequencing Background
• Question #2 — JAK2 Exon 12 Sequencing
• JAK2 Exon 12 Sequencing: When Not to Use
• JAK2 Exon 12 Sequencing
• Conclusion #2 — JAK2 Exon 12 Sequencing
• MPL Exon 10 Sequencing Studies: Background
• Question #3 — MPL Exon 10 Sequencing
• MPL Exon 10 Sequencing: When to Use
• MPL Exon 10 Sequencing: When Not to Use
• MPL Exon 10 Sequencing
• Conclusion #3 — MPL Exon 10 Sequencing
• Roles of Other Assays in Classic MPN
• Summary
• Myeloproliferative Neoplasm: A Diagnostic Approach to Peripheral Blood Evaluation
• Myeloproliferative Neoplasm: A Diagnostic Approach to Bone Marrow Evaluation
• Implementing a Utilization Approach
• Questions