Medical

Letter from Dr M at King's to my GP following the last consultation, when he had the result of the JAK2 test. He doesn't say, though it was said at the time, that he also needs a test for iron in the blood for a complete diagnosis. The bone marrow biopsy is on July 19, with follow-up consultation July 29.


Diagnosis: ? Myeloproliferative disorder
Disease status: At diagnosis
Follow up: Three to four weeks
FBC: Haemoglobin 10.2, WCC 2.7, platelets 1031

Lord Avebury was reviewed in clinic today. A JAK II analysis was negative but 1 note a C-MPL mutation was positive, which is strongly suggestive of myeloproliferative disorder. This taken together with his rise in platelets counts is indeed suggestive of this diagnosis rather than a reactive thrombocytosis.

I have asked him to have a bone marrow examination to try and confirm the diagnosis at his earliest convenience and we will review him with the results. It seems highly likely that if we do indeed confirm the diagnosis that we will need to start him on some form of platelet reductive therapy. Although he is asymptomatic he is at increased risk of thrombosis as a consequence of a platelet count above 1,000, his age and cardiovascular morbidity.

I will bring him back to see me with the results of his investigations and we will proceed as above once these results are available.