Diagnostic Criteria for Polycythemia Vera (PV)

Criteria PVSG (Polycythemia Vera Study Group)

A1 Raised red cell mass (RCM), male > 36 ml/kg, female > 32 ml/kg

A2 Normal arterial oxygen saturation > 92%

A3 Splenomegaly

B1 Platelet count > 400 x 109/l

B2 White blood cell count (WBC) > 12 x 109/l

B3 Leucocyte alkaline phosphatase > 100

B4 Serum B12 > 900 pg/ml or unbound B12 binding capacity > 220 pg/ml

Diagnosis

A1 + A2 + A3 establishes PV

A1 + A2 + two of category B establishes PV

Criteria BCSH (British Committee for Standards in Haematology)

A1 Raised RCM or hematocrit (HCT) > 0.60 (males), > 0.56 (females)

A2 No secondary erythrocytosis

A3 Palpable spleen

A4 Abnormal karyotype

B1 Platelet count > 400 x 109/l

B2 Neutrophil count > 10 x 109/l

B3 Splenomegaly on ultrasound scanning

B4 Low serum EPO or characteristic burst forming units – erythroid (BFU-E) growth

Diagnosis

A1 + A2 + A3 or A4 establishes PV

A1 + A2 + two of B establishes PV

Criteria WHO (World Health Organization)

A1 Raised RCM or haemoglobin (Hb) > 18.5 (males), > 16.5 (females)

A2 No secondary erythrocytosis

A3 Splenomegaly

A4 Abnormal karyotype (other than Ph chromosome or BCR/ABL fusion gene in marrow cells)

A5 Endogenous erythroid colony (EEC) formation

B1 Platelet count > 400 x 109/l

B2 WBC > 12 x 109/l

B3 Bone marrow biopsy (BMB) showing panmyelosis with erythroid and megakaryocytic proliferation

B4 Low serum erythropoietin (EPO)

Diagnosis

A1 + A2 and any other category A establishes PV

A1 + A2 + two of category B establishes PV