Page 69 - Haematologica Atlas of Hematologic Cytology
P. 69

CHAPTER 8 - Myeloproliferative neoplasms
EF
Figure 10 Primary myelo brosis (PMF) Peripheral blood ndings of PMF PMF include anisopoikilocytosis with dacryocytosis (teardrop-shaped red cells) occasional erythroblasts (A) and and and immature granulocytes (B) (leukoerythroblastosis) The presen- ce ce ce ce ce ce of of of of dysplas c c c c c c c c c c c c c c c c neutrophils (C) an an an an an an an an increased increased percentage (10-19%) of of of of blast blast blast cells cells cells (D and and and and and ) ) ) ) ) ) ) and/or and/or increased increased CD34 cells cells cells in in in in the the PB and/or and/or bone bone marrow marrow are indica ve ve ve of of of of of accelerated phase of of of of of the the the the disorder Thrombocytosis with platelet anisocytosis and and and and and marked morphological altera ons is is is is is is is very frequent ( and and and F) In the the the the the overt bro bro c c c c c c c c c c c c c stage the the the the the presence of of of of of bone bone marrow marrow re re re re re re re cu- lar or or or or collagen brosis brosis requires the the the the execu on on on on on of of of a a a a a a a a a a a a a a a a a a a a a a a a a trephine biopsy which is is is is also useful for the the the the evalua on on on on on of of of megakaryocyte morphology Megakaryocy c c c c c c c c c c c c c c c prolifera on on on on and and and atypia without re re re re re re re culin culin brosis brosis brosis grade grade >1 associated with with granulocy c c c c c c c c c c c c c c c pro- lifera lifera on on and and and o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o en en decreased erythropoiesis or or or or or or or or accompanied by re re re re re re culin culin and/or collagen brosis brosis grades 2 2 or or or or or or or or 3 are ma ma or or or or or or or or diagnos c c c c c c c c c c c c c criteria criteria for PMF pre pre pre bro bro bro c/early stage stage or or or or or or or or or overt bro bro bro c c c c c c c c c c c c c stage stage respec vely (Thiele et al 2017) The other other other major criteria criteria criteria are are represented by exclusion of of of other other other myeloid neoplasms
and presence of of of JAK2 CALR or or or or or or or MPL muta on on on or or or or or or or another clonal marker or or or or or or absence of of of reac ve ve brosis Minor criteria criteria criteria are: anemia leukocytosis ≥11x109/L palpable splenomegaly increased lactate dehydrogenase level leukoerythroblastosis All 3 ma ma or or or or criteria criteria and at at least 1 1 1 1 minor criterion must be met 56































































































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