BCR::ABL1 screening is not indicated in patients with splenomegaly without neutrophilia and/or basophilia

The underlying causes of splenomegaly are myriad and include acute, chronic and tropical infections; haematological malignancies (both acute and chronic, myeloid and lymphoid); non-neoplastic haematological conditions (thalassaemia, autoimmune haemolysis); congestive causes (cirrhosis, cardiac failure); inflammatory conditions (systemic lupus erythematosus, sarcoidosis); neoplastic causes (haemangioma, metastases) and infiltrative processes (Gaucher’s disease, amyloidosis).1 Chronic myeloid leukaemia (CML) is a haematopoietic stem cell–derived myeloproliferative neoplasm, molecularly characterised by the presence of the BCR::ABL1 oncogene and which has become the paradigm for molecularly targeted therapy in oncology. The common presenting haematological features of CML are neutrophil leucocytosis with left shift, basophilia and eosinophilia, with the most frequent physical presenting feature being splenomegaly, present in 60%–75% of patients.2 3 Because of this clinicopathological association, molecular testing for BCR::ABL1 is a recurrent request in patients presenting with splenomegaly without other haematological abnormalities associated with CML. A brief audit was, therefore,...
Source: Journal of Clinical Pathology - Category: Pathology Authors: Tags: PostScript Source Type: research