Concomitant essential thrombocythemia and mature b-lymphoproliferative disorder in a patient

Ayesha Butt, Ruhul Quddus, Natasha Ali

Research output: Contribution to journalArticlepeer-review


A-64-year old male presented with cough, weight loss, and maculopapular rash for 15-20 days. On examination, he was found to have cervical lymphadenopathy and splenomegaly. His leukocyte count was 62.1x109/L, platelets were 1169x109/L and LDH was 816 IU/L. Peripheral blood film showed a leukoerythroblastic picture with thrombocytosis. He was started on hydroxyurea and allopurinol. Subsequently, bone marrow evaluation was done which depicted increased lymphoid cells with an M:E ratio of 4:1. Cellular areas exhibited an increase in myeloid precursors along with prominent lymphoid cells and abundant megakaryocytes. Immunohistochemistry showed an increase in B-lymphocytes. Grade MF-2 reticulin fibrosis was noted. Overall findings suggested essential thrombocythemia (ET). On flow cytometry, CD45-positive lymphoid cells population was 31% and showed reactivity to Pan-B-markers with lambda light chain restriction. Janus Kinase 2 (JAK 2) mutation was detected while BCR-ABL1 translocation was negative. A diagnosis of ET progressing to myelofibrosis and mature B-lymphoproliferative disorder was made. Hydroxyurea and allopurinol were stopped while ruxolitinib was introduced and 2.5 years later he remains stable on this treatment.

Original languageEnglish
Pages (from-to)255-259
Number of pages5
JournalInternational Journal of Hematology-Oncology and Stem Cell Research
Issue number4
Publication statusPublished - 2021


  • Essential thrombocythemia
  • Janus kinase 2 (JAK2) V617F
  • Lymphoproliferative disorder


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