Changes in my labwork

[WRLM]

I was diagnosed with jak2+ ET in March 2023 (though BMB report said they couldn’t rule out pre-fibrotic MF?)

My hematologist immediately went on a 3-month sabbatical, so I’ll be meeting her next week for the first time. I’ve also managed to get a referral to an MPN specialist, but that appt isn’t until October.

I just had some labwork done in prep for my hematology appt next week. Up until now I’ve only ever had platelets out of range (which has been the case since 2015, despite my recent diagnosis.)

This time my WBC and neutrophils are also high. I’ll hear what the hematologist thinks in 10 or so days, but in the meantime I’m curious how you experienced folks would interpret this new change? Is it significant? Do you think it’ll impact my diagnosis?

I’ve been on daily aspirin since the end of March, but nothing else.

Interested to hear your thoughts, and any questions I should add to my list.

[mhos61]

It could be something as simple as an infection/inflammation causing the elevation in your wbc.

At this stage, I wouldn’t worry too much, it’s something you can discuss with your haematologist in clinic.

[Planti]

I agree with mhos61, that pattern is often associated with infection. By any chance is there more information on the WBC panel, at the bottom?

Occult infections can be anywhere, but if there is no obvious infection perhaps dental inflammation or a UTI that is asymptomatic?

Hope you feel okay and good that you got the MPN specialist referral. Will you see her in person or by phone? I am going to have another BMB this fall to see if my marrow has normalized on interferon, there is a slight chance that I may be able to come off of it for a time. It is pretty tolerable but does make me somewhat more tired.

Let us know how it goes, Lauren

[WRLM in reply to Planti]

This is a relief to hear while I wait - thank you!

I feel pretty good overall, but I do seem to get random inflammation, and have for years.

Usually it’s my fingers/hands/wrists, but the night before the blood draw my knee randomly swelled up, was hot to the touch (no redness) and it hurt to bend. It started randomly in the evening. I woke up the next morning and it was fine. I’ve never had any knee issues/injuries before. I’m curious to chat with the specialist and see if that stuff is related somehow?

I’ve seen 2 rheumatologists in the past 8-ish years (pre-MPN diagnosis) and both said I don’t have RA, despite the ongoing issues with my fingers & hands.

I’ll attach a photo of the rest of the CBC panel results. The part that is cut off reads that the “RBC morphology is essentially normal.”

She did so some addition kidney/liver tests that all came back in the normal range. This is the first time I’ve had anything besides the platelets out of range, so it was a bit of a surprise.

I’ll meet the hematologist who diagnosed me next week in person. I’ll see the MPN specialist in person as well, but not until October. It will be nice to finally meet some dr’s in person and address my ever growing list of questions!!

Thank you for replying! Sounds like there may be a simple explanation and no need to start worrying. Being able to access our own lab results is a blessing and a curse sometimes! Lol

[Planti]

While you wait for your haematologist appointment it might be worthwhile having the test repeated now that your knee is fine, would be good to see the neutrophils going the other way. A chat with your FP?

Good to hear that all other tests were normal.

I have issues with a lot of joints and it is all osteo arthritis but seems like a generalized type as I have never been athletic or had any trauma to joints, well except for my dog walking injury to my left shoulder. Joint pain is more of a bother to me than the MPN.

All the best, Lauren

[Solyesh]

Of course your doctor will need to chime in but one out of range reading can definitely mean it is reactive (infection; inflammation etc.) - the trend is almost always more important. Prior to starting on Peg, I had had elevated WBC almost consistently (ET; Kak2+)