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

Godfrey, AL.; Sousos, N.; Frewin, R.; Prahladan, M.; Green, AC.; McGregor, A.; Khan, A.; Milne, K.; Amin, F.; Torre, E.; Gudgin, EJ.; Lambert, J.; Wilson, AJ.; Royston, D.; Harrison, CN.; Mead, AJ.

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

All Authors

Godfrey, AL.

Sousos, N.

Frewin, R.

Prahladan, M.

Green, AC.

McGregor, A.

Khan, A.

Milne, K.

Amin, F.

Torre, E.

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LTHT Author

Khan, Alesia

LTHT Department

Haematology

Publication Date

2024

Item Type

Journal Article
Multicenter Study

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.