APPLICABILITY OF THE 2016 WHO DIAGNOSTIC CRITERIA FOR POLYCYTHEMIA RUBRA VERA IN SULAIMANIYAH CITY, KURDISTAN REGION, IRAQ

Shang Ibrahim Nuri; Hisham Arif Getta; Najmaddin Salih Husen Khoshnaw

doi:10.46903/gjms/22.03.1708

APPLICABILITY OF THE 2016 WHO DIAGNOSTIC CRITERIA FOR POLYCYTHEMIA RUBRA VERA IN SULAIMANIYAH CITY, KURDISTAN REGION, IRAQ

Shang Ibrahim Nuri, Hisham Arif Getta, Najmaddin Salih Husen Khoshnaw

Abstract

Background: Polycythemia Rubra Vera (PRV) is a myeloproliferative neoplasm characterized by uncontrolled red blood cell production. This study aimed to evaluate the applicability of the 2016 WHO diagnostic criteria for PRV in Sulaimaniyah City, Kurdistan Region, Iraq, focusing on the incidence of JAK2 mutations and their association with patient demographics and clinical features.

Materials & Methods: A cross-sectional retrospective study was conducted on 100 PRV patients between February 2023 and February 2024 at Hiwa Hematology/Oncology Hospital and Shorsh Teaching Hospital. Patients were selected using a convenience sampling method, which involved including all eligible patients with available JAK2 mutation data and bone marrow examination results during the study period. Blood parameters, bone marrow examination, and JAK2 mutation status were analyzed. Statistical associations between JAK2 mutation status and age, gender, and clinical features (neutrophilia, thrombocytosis, splenomegaly) were assessed.

Results: The mean age of the patients was 52.91 ± 16.76 years, with 51% older than 50 years. Males comprised 68% of the cohort. Among the patients, 47% were JAK2 mutation-positive, and 53% were JAK2-negative. JAK2-positive patients were significantly older (mean age 57.51 ±17.84 years) compared to JAK2-negative patients (mean age 48.83 ± 14.73 years; p=0.009). A significant association was found between JAK2 mutation status and gender (p=0.01), with a higher proportion of males among JAK2-negative patients. JAK2-positive patients showed higher incidences of neutrophilia (25.5% vs. 3.8%; p=0.002), thrombocytosis (46.8% vs. 13.2%; p<0.001), and splenomegaly (53.2% vs. 9.4%; p<0.001) compared to JAK2-negative patients.

Conclusions: The study revealed that while the 2016 WHO criteria are generally effective for diagnosing PRV, the higher-than-expected proportion of JAK2-negative patients suggests the need for additional diagnostic considerations in this population. The significant associations between JAK2 mutation status and specific clinical features emphasize the heterogeneity of PRV presentations and the potential need for regional adaptations of the WHO criteria.

Keywords

Janus kinase 2 mutation; Neutrophilia; Polycythemia Rubra Vera; Splenomegaly.

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DOI: https://doi.org/10.46903/gjms/22.03.1708