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Xueya Zhang, Jing-xin Pan, Jian-xin Guo (2013)
Presence of the JAK2 V617F Mutation in a Patient with Chronic Neutrophilic Leukemia and Effective Response to Interferon Alfa-2bActa Haematologica, 130
I read with interest the case report of Zhang et al. [1] of a JAK2 V617F mutation in chronic neutrophilic leukaemia (CNL). However, I should like to suggest that an alternative diagnosis be considered. The platelet count was 628 × 109/l with no description of megakaryocyte morphology being given. Following the 2008 WHO criteria for a diagnosis of CNL, it is required that there be ‘no evidence of essential thrombocythaemia' [2]. This platelet count meets the WHO criteria for a diagnosis of essential thrombocythaemia, and in that condition the JAK2 mutation would not be at all surprising. Admittedly, the WHO authors also state that in essential thrombocythaemia the white cell count is usually normal, although a borderline elevation may occur [3]. The situation is not straightforward, but the case appears closer to essential thrombocythaemia than to CNL. In addition, the possibility of prefibrotic myelofibrosis should also be considered when assessing the trephine biopsy sections.
Acta Haematologica – Karger
Published: Jan 1, 2013
Keywords: Chronic leukemia
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