Essential Thrombocythaemia

Essential thrombocythaemia is characterised by an increase in the number of circulating platelets, due to the mutations JAK2, CARL, or MPL (90%), which cause sustained proliferation of megakaryocytes. Patients have a persistently elevated platelet count (>450,000/uL) and splenomegaly, and frequently…

Primary Myelofibrosis

Primary myelofibrosis is characterised by the replacement of bone marrow by fibrous tissue. There are abnormal proliferating megakaryocytes and granulocytes that produce cytokines that stimulate fibrosis. The typical presentation is a patient with anaemia, teardrop RBCs, leukoerythroblastosis, and hepatosplenomegaly. No…

Polycythemia

Polycythemia is a laboratory finding characterised by an increased number of RBCs and an accompanying elevation in haematocrit and haemoglobin concentration in the peripheral blood. It is commonly an incidental finding. Definition of terms Term Definition Relative polycythemia An isolated…

Leukemoid Reactions

A leukemoid reaction is the presence of an elevated leucocyte count of >50 x 10^9/L in a reactive condition outside the bone marrow. Leukemoid reaction vs Chronic myeloid leukaemia Leukemoid reaction Chronic myeloid leukaemia PBF leukocytes Left shift: mature neutrophils,…

Chronic Myeloid Leukaemia (CML)

Chronic myeloid leukaemia is characterised by a single genetic translocation (bcr-abl) in a pluripotent stem cell. It is characterised by increased proliferation of differentiating granulocytic cells. The peripheral blood shows an increased number of granulocytes and occasional blasts. 90-95% of…

Burkitt Lymphoma

Burkitt Lymphoma was first described in 1958 at Mulago Hospital in Uganda. It is characterised by Burkitt cells, which have a very high proliferative rate (more than 90% Ki67 proliferative index and a 24-hour cell turnover rate), and c-MYC gene…