HCDP Manchester

Myeloproliferative Neoplasms (MPN)

PATHWAY OPTIONS
There are a number of choices. Please ensure you select the correct pathway for your sample. Please give as much clinical detail as possible for all samples.

Pathway 8A: Genetic screening tests (blood)

This pathway is designed to investigate PV in uncomplicated cases. If atypical features present (e.g. thrombocytosis or raised white cells) consider one of the alternative pathways below that include BCR::ABL1 analysis. A sample will be retained and can be used for full myeloid panel which may be tested on specific request.
The following tests will be performed:

  • Molecular MPN panel (JAK2/ CALR/ MPL + stored sample)

Pathway 8B: Genetic screening tests inc BCR/ABL1 (blood)

This pathway is used to investigate an MPN that is not a simple erythrocytosis. BCR::ABL1 is required and will need an additional sample. Genetic samples will be retained for additional tests if required.
The following tests will be performed:

  • Molecular MPN panel (JAK2/ CALR/ MPN + stored sample)
  • BCR/ABL1 screening (RNA)

Pathway 8C: Myeloproliferative disorder: marrow assessment

This pathway is for complex cases or suspected myelofibrosis requiring trephine. Repeat genetic testing is advised even if an MPN panel has already been performed on blood, since investigation may be more sensitive using marrow samples.
The following tests will be performed:

  • Morphology marrow
  • Flow cytometry (optional)
  • Trephine
  • Cytogenetics (process if indicated)
  • Molecular: MPD panel (option to extend to full myeloid panel from the same sample on specific request)
  • Molecular BCR/ABL1 screening (RNA)(option to extend to fusion panel if required)