Neutrophilic leukocytosis in advanced stage polycythemia vera: hematopathologic features and prognostic implications

Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc
Leonardo BoiocchiAttilio Orazi

Abstract

Polycythemia vera in 20-30% of cases progresses towards post-polycythemic myelofibrosis, an advanced phase characterized by decreased red blood cells counts and increasing splenomegaly with extramedullary hematopoiesis. There is evidence that the presence of neutrophilic leukocytosis at polycythemia vera disease outset is associated with an increased risk of recurrent thrombosis. However, its clinical significance when developing later in the course of the disease is not well defined. Over a period of 8 years we identified from the files of two reference centers 10 patients (7M/3F, median age: 68 years) who developed persistent absolute leukocytosis ≥ 13 × 10⁹/l (median: 25.1 × 10⁹/l; range: 16.1-89.7 × 10⁹/l) at or around the time of diagnosis of post-polycythemic myelofibrosis (median interval from diagnosis:0 months; range: -6/31) and persisted for a median period of 13 months. Peripheral blood smears showed numerous neutrophils without dysplastic features and, in four, ≥ 10% immature myeloid precursors. In five cases, corresponding marrow specimens obtained at or immediately after the onset of leukocytosis showed a markedly increased myeloid:erythroid ratio due to granulocytic proliferation. No change in JAK2 and BCR-ABL1 s...Continue Reading

References

Nov 16, 2004·The American Journal of Medicine·Francesco PassamontiMario Lazzarino
Oct 8, 2005·Seminars in Hematology·Juergen ThieleAttilio Orazi
Jul 7, 2007·British Journal of Haematology·Naseema GangatAyalew Tefferi
Aug 25, 2012·Blood·Manja MeggendorferSusanne Schnittger
Sep 29, 2012·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Leonardo BoiocchiAttilio Orazi
Dec 12, 2012·Nature Genetics·Rocco PiazzaCarlo Gambacorti-Passerini
Jan 16, 2013·Blood·Raphaël ItzyksonEric Solary
May 10, 2013·The New England Journal of Medicine·Julia E MaxsonJeffrey W Tyner
May 15, 2013·Methods in Molecular Biology·Jonathan S KuiY Lynn Wang
Jun 22, 2013·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Leonardo BoiocchiAttilio Orazi
Dec 18, 2013·Current Opinion in Hematology·Michelle A Elliott, Ayalew Tefferi

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Citations

May 6, 2020·Expert Opinion on Therapeutic Targets·Niccolò BartalucciAlessandro M Vannucchi
Aug 20, 2017·Current Hematologic Malignancy Reports·Aaron C Shaver, Adam C Seegmiller
Apr 25, 2019·International Journal of Molecular Sciences·Alessandra IurloUmberto Gianelli

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