Some patients with polycythemia vera do not meet the criteria set forth by the Polycythemia Vera Study Group. Hoffman and Boswell suggest criteria that may be more flexible for diagnosis of polycythemia vera.
Criteria
Corresponding PVSG criteria
increased red cell mass (males >= 36 mL/kg, females >= 32 mL/kg)
A1
normal arterial oxygen saturation >= 92%
A2
splenomegaly
A3
thrombocytosis with platelet count > 400,000 per µL, and leukocytosis > 12,000 per µL, in the absence of fever or infection
B1+B2
bone marrow hypercellularity associated with megakaryocytic hyperplasia and absent iron stores
NA
low serum erythropoietin levels (< 30 mU/mL) in the presence of increased red cell mass, as outlined above
NA
tissue culture of bone marrow shows formation of erythroid colonies in the absence of exogenous erythropoietin
NA
Interpretation:
• Polycythemia vera is present if at least 4 of the above criteria are met.
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