Polycythemia Vera – Diagnostic Criteria

WHO 2016 diagnostic criteria for polycythemia vera. The National Comprehensive Cancer Network (NCCN) and European LeukemiaNet (ELN) both recommend using the WHO 2016 diagnostic criteria for most accurate diagnosis. Hemoglobin thresholds for men and women were lowered in the 2016 revision to the WHO diagnostic criteria (16.5 g/dL for men or 16 g/dL for women) to include most cases of masked PV that were missed by the 2008 WHO criteria (18.5 g/dL for men and 16.5 g/dL for women).

The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia:

Polycythemia vera (PV) criteria were revised from the 2008 WHO criteria because “it is possibly underdiagnosed using the hemoglobin levels published in the fourth edition (2008 version), and the utility of BM morphology as a reproducible criterion for the diagnosis of PV is recognized”.
The diagnostic criteria for PV have been refined to differentiate masked PV from ET (recognizing the utility of bone marrow biopsy in patients with hemoglobin levels <18.5 g/dL in men and <16.5 g/dL in women).
Thus, the major diagnostic criteria for PV have been refined to include hemoglobin levels (>16.5 g/dL in men and >16.0 g/dL in women) or hematocrit >49% in men and >48% in women and a bone marrow biopsy to confirm the age-matched hypercellularity.

The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia:

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