The Classic Myeloproliferative Neoplasms

Myeloproliferative Neoplasm: A Diagnostic Approach to Peripheral Blood Evaluation

October 2011

In the next 2 slides, I would like to introduce to you 2 algorithms that are available on the Mayo Medical Laboratories Web page that summarize our approach to the MPNs, whether in blood or bone marrow. In peripheral blood, if JAK2 V617F is positive, then understanding the CBC and serum erythropoietin values will determine whether or not you can make the diagnosis of PV by peripheral blood studies. If the JAK2 is negative or equivocal and PV is still possible on the basis of the CBC and serum erythropoietin, then JAK2 exon 12 sequencing should be performed. If, however, the CBC and serum erythropoietin do not support PV, then the next steps revert to whether or not there is clinical suspicion for a myeloproliferative neoplasm. That will determine the necessity of doing a bone marrow study or not.

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Diagnostic Peripheral Blood Evaluation

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Jump to section:

• 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