Thank you for everyone’s contributions so far!

Update of investigation results as requested:

• Bone marrow trephine: myelofibrosis.
• BM cytogenetics: monosomy 7
• Peripheral blood: JAK2 positive. No circulating blasts identified on blood film.
• USS abdo: 16cm spleen
• (Hb 95, Plts 90, WCC 17. Weight loss)

Correlating the above results the diagnosis is Primary Myelofibrosis as most of you have correctly suggested (no known prior MPD or reactive causes for secondary MF identified).

Questions

• How would you want to manage this 64 year old, otherwise fit male?

Please reply to us (@TeamHaem) on Twitter and always include #TeamHaem to allow others to follow your comments. Please join in the debate and learn about haematological problems along the way. The case will continue to evolve over the coming week so keep checking #TeamHaem on Twitter for more information.

Please note – all cases on TeamHaem are entirely fictional to protect patient confidentiality.

TeamHaem are not a position of authority. It is an educational platform to allow discussion and learning