CD34+ megakaryocytes (≥30%) are associated with megaloblastic anaemia and non-acute myeloid neoplasia.
OBJECTIVE
To evaluate the sensitivity and specificity of CD34 staining of megakaryocytes (MKs), in order to distinguish non-neoplastic and neoplastic bone marrows (BMs).


RESULTS
Three hundred BMs (120 non-neoplastic and 180 neoplastic) were evaluated for percentage and intensity of CD34 staining of MKs. The selected non-neoplastic cases included anaemia, autoimmune conditions, immune thrombocytopenia (ITP), and staging BMs. The neoplastic cases included myelodysplastic syndromes and/or myeloproliferative neoplasms (MDS, MPN, MDS/MPN). Eight per cent of non-neoplastic (9/120) cases and 13% of neoplastic (24/180) cases showed ≥30% CD34+ MKs, and these were essentially restricted to cases of megaloblastic anaemia (MBA) and non-acute myeloid neoplasms. The finding of ≥30% CD34+ MKs did not distinguish between categories of non-acute myeloid neoplasms. MDS cases with ≥30% CD34+ MKs had lower platelet counts than cases with <30% (P = 0.03).


CONCLUSIONS
In complex BM cases, the presence of ≥30% CD34+ MKs constitutes a potentially useful diagnostic tool with which to distinguish non-acute myeloid neoplasms and MBA from non-MBA reactive conditions, for minimal additional cost.
Departments of PathologyInternal Medicine and Biostatistics, University of New Mexico, Albuquerque, NMDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
Giovanni
G
Insuasti-Beltran
Nichole L
NL
Steidler
Huining
H
Kang
Kaaren K
KK
Reichard
D000749:Anemia, Megaloblastic / Q000175:diagnosis*; D018952:Antigens, CD34 / Q000032:analysis / Q000096:biosynthesis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D001854:Bone Marrow Cells / Q000473:pathology; D019337:Hematologic Neoplasms / Q000175:diagnosis*; D006801:Humans; D007150:Immunohistochemistry; D008533:Megakaryocytes / Q000473:pathology*
D018952:Antigens, CD34; D014408:Biomarkers, Tumor