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Polycythaemia Vera — RACP Adult Medicine MCQ

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HardHaematologyPolycythaemia VeraRACP Adult Medicine

A 68-year-old has persistent platelets 950 x 10^9/L, a JAK2 V617F variant, normal haemoglobin, no reactive cause and marrow megakaryocytic proliferation without significant fibrosis. What is the most likely myeloproliferative neoplasm?

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Correct answer: E — Essential thrombocythaemia with a JAK2 driver

The best answer is “Essential thrombocythaemia with a JAK2 driver”. Sustained clonal thrombocytosis with characteristic megakaryocytes, a JAK2 driver and no erythrocytosis, BCR-ABL1 or overt fibrosis supports essential thrombocythaemia. Age above 60 and JAK2 positivity increase thrombotic risk and prompt assessment for low-dose aspirin and cytoreduction according to bleeding risk and comorbidity.

Reference: Leukaemia Foundation: Myeloproliferative neoplasms: https://www.leukaemia.org.au/types-of-blood-cancer/myeloproliferative-neoplasms-mpn/