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Multicenter Study
. 2024 Oct;205(4):1411-1416.
doi: 10.1111/bjh.19643. Epub 2024 Jul 14.

Clinical utility of investigations in triple-negative thrombocytosis: A real-world, multicentre evaluation of UK practice

Anna L Godfrey  1 , Nikolaos Sousos  2   3 , Rebecca Frewin  4 , Mahesh Prahladan  1 , Anna C Green  5 , Andrew McGregor  6 , Alesia Khan  7 , Kate Milne  1 , Faisal Amin  8 , Elena Torre  8   9 , Emma J Gudgin  1 , Jonathan Lambert  10 , Andrew J Wilson  10 , Daniel Royston  11 , Claire N Harrison  8 , Adam J Mead  2   3
Affiliations
Multicenter Study

Clinical utility of investigations in triple-negative thrombocytosis: A real-world, multicentre evaluation of UK practice

Anna L Godfrey et al. Br J Haematol. 2024 Oct.

Abstract

Diagnosis of essential thrombocythaemia (ET) is challenging in patients lacking JAK2/CALR/MPL mutations. In a retrospective evaluation of 320 patients with 'triple-negative thrombocytosis', we assessed utility of bone marrow histology (90.9% of patients) and myeloid gene panel (MGP, 55.6%). Supportive histology ('myeloproliferative neoplasm-definite/probable', 36.8%) was associated with higher platelet counts and varied between centres. 14.6% MGP revealed significant variants: 3.4% JAK2/CALR/MPL and 11.2% other myeloid genes. Final clinical diagnosis was strongly predicted by histology, not MGP. 23.7% received cytoreduction (17.6% under 60 years). Real-world 'triple-negative' ET diagnosis currently depends heavily on histology; we advocate caution in MGP-negative cases and that specific guidelines are needed.

Keywords: diagnosis; molecular; myeloproliferative; thrombocytosis; triple‐negative.

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References

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