Bone marrow aspiration shows Philadelphia chromosome

Chief Complaint A 75 y/o female referred for thrombocytosis that was noted during routine checks. History HTN, DM and cerebral ischemic attack. Physical Examination Examination shows no specific finding. Investigations Philadelphia chromosome positivity was determined at conventional bone marrow aspiration chromosome analysis. Thrombocytes: 705×10 9/L (Normal range:150-450×10 9) Hemoglobin: 14.7 g/dL (Normal range:12-17) WBC: 5.6×10 9/L (5-10×10 9) Neutrophil % 60.8 (40-60) Lymphocytes % 33.7 (25-35) Eosinophils % 1.7 (1-5) Basophils % 0.6 (0-1) Monocytes % 5.6 (5-10) Uric acid (mg/dL) 4.6 (2.6-7.2) Diagnosis Please give your valuable opinion. Treatment Advise management also.

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CBC dose not show feature of CML.lt might be a case of philadelphia positive essential thromocythemia.What is the morphology of megakaryocytes in bone marrow?. It may also be a case of stable CML. Follow up nedeed.

Blood picture does not favour CML. Ph chromosome is not specific for cML ALSO seen in.. ALL AML MPAL.. mixed phenotype acute leukaemia. ph positive essential thrombocythaemia Sug. Clinical and haematological correlation Follow up study

Thrombocytosis is seen in myelofibrosis ,and essential thrombocytosis, and is unusual in CML ,and ALL. Presence of Philadelphia chromosome favours diagnosis of CML. Unusual case of combination of Ph and thrombocytosis

Thrombocytosis will increase because of dehydration & poor control of diabetese. philaphedia chromosome positive found in AML & CML bone cancer in which thrombocytosis may occured

Philadelphia chromosome positivity shows CML. Thrombocytosis is also there. Thrombocytosis is very common finding in CML