Is my positive BCR/ABL test indicative of CML?

Question

Hello doctor,

My platelets have always been high, in the range of 600 to 700. My other blood count is within the normal range.

Ten years ago, I had two BCR or ABL tests (peripheral blood) to rule out CML(chronic myelocytic leukemia). One test came back positive and the other negative. Which test should I believe? The first test was done with multiplex PCR with a positive result. The second test was done with qualitative reverse transcriptase-PCR with negative results.

I had a JAK2-plus test drawn with peripheral blood, and it returned positive. Based on this, the doctor diagnosed me with essential thrombocytosis. Does the presence of the JAK2-plus gene automatically rule out CML?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

The mere presence of BCR-ABL does not confirm CML (chronic myelogenous leukemia). It has leukocytosis, splenomegaly, positive Philadelphia chromosome or other cytogenetic abnormality, BM hyperplasia, etc. A negative BCR-ABL by qRT-PCR excludes it without the signs mentioned above. Moreover, a high platelet count might be part of CML instead of the only feature of CML.

However, a positive JAK2 with persistent thrombocytosis indicates essential thrombocythemia (ET). So, now you have JAK2-positive ET. Get back for treatment of ET with a fresh CBC (complete blood count).

I hope this helps.

Kindly revert in case of further queries.

Thank you.