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Erschienen in: International Journal of Hematology 2/2021

22.05.2021 | Original Article

Evaluation of beta-2 microglobulin, erythropoietin and tobacco use in polycythemic cases

verfasst von: Kristell Mahe, Francis Couturaud, Hélène Kerspern, Aurélie Chauveau, Jean-Christophe Ianotto

Erschienen in: International Journal of Hematology | Ausgabe 2/2021

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Abstract

In the 2016 WHO classification, hemoglobin and hematocrit thresholds for diagnosing polycythemia vera (PV) have been lowered, increasing the number of consultations for polycythemia investigations. In PV, beta-2 microglobulin (B2m) levels are reportedly increased, whereas erythropoietin (EPO) levels are usually low. Most secondary polycythemia cases (SP) are caused by tobacco use. We decided to analyze the relevance of these three parameters in all patients seen for polycythemia investigations to help differentiate PV from SP cases. A cohort of 257 patients (123 PV; 134 SP) was identified. The median B2m level was higher for PV patients (3.16 vs 1.98 mg/l, p < 0.0001). Increased B2m levels were observed in 83.7% of PV patients (11.9% in SP). The median EPO level was lower in PV patients (4.4 vs 12.3 UI/l, p < 0.0001). Tobacco was used by 42.8% of SP patients (8% in PV, p < 0.0001). Increased B2m, low EPO and no tobacco exposure was predictive of PV (specificity and positive predictive value = 100%). Normal B2m, normal EPO and tobacco exposure was predictive of SP (positive predictive value = 100%). These simple and inexpensive parameters could be used to rapidly differentiate PV from SP cases, before prescribing time-consuming JAK2 V617F mutation analysis by specialists.
Literatur
1.
Zurück zum Zitat Barbui T, Thiele J, Gisslinger H, Kvasnicka HS, Vannucchi AM, Guglielmelli P, et al. The 2016 WHO classification and diagnostic criteria for myeloproliferative neoplasms: document summary and in-depth discussion. Blood Cancer J. 2018;8:15.CrossRef Barbui T, Thiele J, Gisslinger H, Kvasnicka HS, Vannucchi AM, Guglielmelli P, et al. The 2016 WHO classification and diagnostic criteria for myeloproliferative neoplasms: document summary and in-depth discussion. Blood Cancer J. 2018;8:15.CrossRef
2.
Zurück zum Zitat Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016;127:2391–405.CrossRef Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016;127:2391–405.CrossRef
3.
Zurück zum Zitat Vardiman JW, Thiele J, Arber DA, Brunning RD, Borowitz MJ, Porwit A, et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood. 2009;114:937–51.CrossRef Vardiman JW, Thiele J, Arber DA, Brunning RD, Borowitz MJ, Porwit A, et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood. 2009;114:937–51.CrossRef
4.
Zurück zum Zitat Barbui T, Thiele J, Gisslinger H, Finazzi G, Carobbio A, Rumi E, et al. Masked polycythemia vera (mPV): results of an international study. Am J Hematol. 2014;89:52–4.CrossRef Barbui T, Thiele J, Gisslinger H, Finazzi G, Carobbio A, Rumi E, et al. Masked polycythemia vera (mPV): results of an international study. Am J Hematol. 2014;89:52–4.CrossRef
5.
Zurück zum Zitat Keohane C, McMullin MF, Harrison C. The diagnosis and management of erythrocytosis. Br Med J. 2013;347:f6667.CrossRef Keohane C, McMullin MF, Harrison C. The diagnosis and management of erythrocytosis. Br Med J. 2013;347:f6667.CrossRef
6.
Zurück zum Zitat James C, Ugo V, Le Couédic JP, Staerk J, Delhommeau F, Lacout C, et al. A unique clonal JAK2 mutation leading to constitutive signalling causes polycythaemia vera. Nature. 2005;434:1144–8.CrossRef James C, Ugo V, Le Couédic JP, Staerk J, Delhommeau F, Lacout C, et al. A unique clonal JAK2 mutation leading to constitutive signalling causes polycythaemia vera. Nature. 2005;434:1144–8.CrossRef
7.
Zurück zum Zitat Sandes AF, Gonçalves MV, Chauffaille ML. Frequency of polycythemia in individuals with normal complete blood cell counts according to the new 2016 WHO classification of myeloid neoplasms. Int J Lab Hematol. 2017;39:528–31.CrossRef Sandes AF, Gonçalves MV, Chauffaille ML. Frequency of polycythemia in individuals with normal complete blood cell counts according to the new 2016 WHO classification of myeloid neoplasms. Int J Lab Hematol. 2017;39:528–31.CrossRef
8.
Zurück zum Zitat Cooper EH, Plesner T. Beta-2-microglobulin review: Its relevance in clinical oncology. Med Pediatr Oncol. 1980;8:323–34.CrossRef Cooper EH, Plesner T. Beta-2-microglobulin review: Its relevance in clinical oncology. Med Pediatr Oncol. 1980;8:323–34.CrossRef
9.
Zurück zum Zitat Norfolk DR, Child JA, Roberts BE, Forbes MA, Cooper EH. Serum beta-2-microglobulin in disorders of myeloid proliferation. Acta Haematol. 1983;69:361–8.CrossRef Norfolk DR, Child JA, Roberts BE, Forbes MA, Cooper EH. Serum beta-2-microglobulin in disorders of myeloid proliferation. Acta Haematol. 1983;69:361–8.CrossRef
10.
Zurück zum Zitat Melillo L, Musto P, Tomasi P, Cascavilla N, Bodenizza C, Ladogana S, et al. Serum beta 2-microglobulin in malignant lymphoproliferative disorders. Tumori. 1988;74:129–35.CrossRef Melillo L, Musto P, Tomasi P, Cascavilla N, Bodenizza C, Ladogana S, et al. Serum beta 2-microglobulin in malignant lymphoproliferative disorders. Tumori. 1988;74:129–35.CrossRef
11.
Zurück zum Zitat Bento L, Díaz-López A, Barranco G, Martín-Moreno AM, Baile M, Martín A, et al. Grupo Español de Linfomas y Trasplante Autólogo (GELTAMO) New prognosis score including absolute lymphocyte/monocyte ratio, red blood cell distribution width and beta-2 microglobulin in patients with diffuse large B-cell lymphoma treated with R-CHOP: Spanish Lymphoma Group Experience (GELTAMO). Br J Haematol. 2020;188:888–97.CrossRef Bento L, Díaz-López A, Barranco G, Martín-Moreno AM, Baile M, Martín A, et al. Grupo Español de Linfomas y Trasplante Autólogo (GELTAMO) New prognosis score including absolute lymphocyte/monocyte ratio, red blood cell distribution width and beta-2 microglobulin in patients with diffuse large B-cell lymphoma treated with R-CHOP: Spanish Lymphoma Group Experience (GELTAMO). Br J Haematol. 2020;188:888–97.CrossRef
12.
Zurück zum Zitat Greipp PR, San Miguel J, Durie BG, Crowley JJ, Barlogie B, Bladé J, et al. International staging system for multiple myeloma. J Clin Oncol. 2005;23:3412–20.CrossRef Greipp PR, San Miguel J, Durie BG, Crowley JJ, Barlogie B, Bladé J, et al. International staging system for multiple myeloma. J Clin Oncol. 2005;23:3412–20.CrossRef
13.
Zurück zum Zitat Mansier O, Migeon M, Etienne G, Bidet A, Lippert E. JAK2V617F and CALR double mutations are more frequently encountered in patients with low JAK2V617F allelic burdens. Leuk Lymphoma. 2016;57:1949–51.CrossRef Mansier O, Migeon M, Etienne G, Bidet A, Lippert E. JAK2V617F and CALR double mutations are more frequently encountered in patients with low JAK2V617F allelic burdens. Leuk Lymphoma. 2016;57:1949–51.CrossRef
14.
Zurück zum Zitat Ancochea A, Alvarez-Larrán A, Morales-Indiano C, García-Pallarols F, Martínez-Avilés L, Angona A, et al. The role of serum erythropoietin level and JAK2 V617F allele burden in the diagnosis of polycythaemia vera. Br J Haematol. 2014;167:411–7.CrossRef Ancochea A, Alvarez-Larrán A, Morales-Indiano C, García-Pallarols F, Martínez-Avilés L, Angona A, et al. The role of serum erythropoietin level and JAK2 V617F allele burden in the diagnosis of polycythaemia vera. Br J Haematol. 2014;167:411–7.CrossRef
15.
Zurück zum Zitat Girodon F, Lippert E, Mossuz P, Dobo I, Boiret-Dupré N, Lesesve JF, et al. JAK2V617F detection and dosage of serum erythropoietin: first steps of the diagnostic work-up for patients consulting for elevated hematocrit. Haematologica. 2007;92:431–2.CrossRef Girodon F, Lippert E, Mossuz P, Dobo I, Boiret-Dupré N, Lesesve JF, et al. JAK2V617F detection and dosage of serum erythropoietin: first steps of the diagnostic work-up for patients consulting for elevated hematocrit. Haematologica. 2007;92:431–2.CrossRef
16.
Zurück zum Zitat Tefferi A, Pardanani A. Evaluation of “increased” hemoglobin in the JAK2 mutations era: a diagnostic algorithm based on genetic tests. Mayo Clin Proc. 2007;82:599–604.CrossRef Tefferi A, Pardanani A. Evaluation of “increased” hemoglobin in the JAK2 mutations era: a diagnostic algorithm based on genetic tests. Mayo Clin Proc. 2007;82:599–604.CrossRef
17.
Zurück zum Zitat Bourantas KL, Hatzimichael EC, Makis AC, Chaidos A, Kapsali ED, Tsiara S, et al. Serum beta-2-microglobulin, TNF-alpha and interleukins in myeloproliferative disorders. Eur J Haematol. 1999;63:19–25.CrossRef Bourantas KL, Hatzimichael EC, Makis AC, Chaidos A, Kapsali ED, Tsiara S, et al. Serum beta-2-microglobulin, TNF-alpha and interleukins in myeloproliferative disorders. Eur J Haematol. 1999;63:19–25.CrossRef
18.
Zurück zum Zitat Calverley PM, Leggett RJ, McElderry L, Flenley DC. Cigarette smoking and secondary polycythemia in hypoxic cor pulmonale. Am Rev Respir Dis. 1982;125:507–10.CrossRef Calverley PM, Leggett RJ, McElderry L, Flenley DC. Cigarette smoking and secondary polycythemia in hypoxic cor pulmonale. Am Rev Respir Dis. 1982;125:507–10.CrossRef
Metadaten
Titel
Evaluation of beta-2 microglobulin, erythropoietin and tobacco use in polycythemic cases
verfasst von
Kristell Mahe
Francis Couturaud
Hélène Kerspern
Aurélie Chauveau
Jean-Christophe Ianotto
Publikationsdatum
22.05.2021
Verlag
Springer Singapore
Erschienen in
International Journal of Hematology / Ausgabe 2/2021
Print ISSN: 0925-5710
Elektronische ISSN: 1865-3774
DOI
https://doi.org/10.1007/s12185-021-03164-0

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