Date | Summaries of visits and treatments | Diagnostic testing |
---|---|---|
1995 | Polycythemia vera Phlebotomy | Hb 22.2 g/dl, Hct 0.64, WBC 10.1 × 109/L, TPK 162 × 109/L |
2008 | Stable Hb Phlebotomy stopped | Hb 13.3 g/dl |
2009 | Mouth ulcers, prednisolone without effect | Mouth biopsy showed “acute and chronic inflammation.” |
March 2012 | Leukopenia, thrombocytopenia | Bone marrow biopsy showed fibrosis grade 1, “spent phase” polycythemia vera; in retrospect, also hairy cell leukemia. Hb 13.2 g/dl, WBC 2.7 × 109/L, neutrophils 1.4 × 109/L, monocytes 0.1 × 109/L, lymphocytes 1.20.1 × 109/L, TPK 102 × 109/L |
April–May 2013 | Worsening of leukopenia, thrombocytopenia Temporary effect of filgrastim on neutrophils and partly on mouth ulcers | Bone marrow biopsy: increased cellularity and fibrosis grade 2–3; in retrospect, also hairy cell leukemia Hb 11.6 g/dl, WBC 2.4 × 109/L, neutrophils 1.1 × 109/L, monocytes 0.1 × 109/L, lymphocytes 1.20.1 × 109/L, TPK 98 × 109/L |
April 2014 | Myelofibrosis Pancytopenia | Bone marrow biopsy with fibrosis grade 3, osteosclerosis; in retrospect, also AML and hairy cell leukemia Complex cytogenetics Hb 9.7 g/dl, WBC 2.3 × 109/L, neutrophils 0.8 × 109/L, monocytes < 0.1 × 109/L, lymphocytes 1.40.1 × 109/L, TPK 41 × 109/L |
May–August 2014 | Repeated hospitalizations with febrile neutropenia Thalidomide and prednisolone without effect | |
October 2014 | Cladribine, temporary effect | Bone marrow biopsy with suggested AML and hairy cell leukemia |
March 2015 | Death |