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  • Letter to the Editor
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Reply to ‘Re: Essential thrombocythemia in young individuals: frequency and risk factors for vascular events and evolution to myelofibrosis in 126 patients. Alvarez-Larrán et al. Leukemia 2007; 21: 1218–1223’

Leukemia volume 22, page 866 (2008)Cite this article

Alvarez-Larrán et al.1 in their reply letter state that Polycythaemia Vera Study Group criteria are currently used for the diagnosis of chronic myeloproliferative disorders and quote two important publications. Both these publications are recent; however, Carobbio et al.2 retrospectively looked at their database from 1981 to 2006 while the Campbell et al.3 paper quoted comprised a cohort of patients diagnosed with essential thrombocytosis from 1997 to 2002. Hence this study with histological review predated the 2001 WHO classification.4

Alvarez-Larrán et al. are somewhat inconsistent using WHO criteria for diagnosis of primary myelofibrosis in their study but not for essential thrombocythaemia. The fibrosis grading system in their publication5 does not include collagen deposition and is divergent with the current grading system.6 It is interesting to learn that with substantial follow-up (10 years) that myelofibrosis did not develop despite moderate fibrosis in these 20 essential thrombocythaemia patients. There is no doubt that there is considerable difficulty in distinguishing essential thrombocythaemia from early-phase chronic idiopathic myelofibrosis/primary myelofibrosis. For the time being we will have to accept a disagreement in utilization of classification systems.

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References

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Authors and Affiliations

  1. Department of Haematopathology, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia

    D Westerman

  2. Department of Diagnostic Haematology, Royal Melbourne Hospital, Parkville, Victoria, Australia

    S Juneja

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  1. D Westerman
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  2. S Juneja
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Correspondence to D Westerman.

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Westerman, D., Juneja, S. Reply to ‘Re: Essential thrombocythemia in young individuals: frequency and risk factors for vascular events and evolution to myelofibrosis in 126 patients. Alvarez-Larrán et al. Leukemia 2007; 21: 1218–1223’. Leukemia 22, 866 (2008). https://doi.org/10.1038/sj.leu.2404966

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