NCCN Guidelines for Patients® | Myeloproliferative Neoplasms

15 NCCN Guidelines for Patients ® : Myeloproliferative Neoplasms, 2018 Physical exam Doctors often perform a physical exam along with taking a medical history. A physical exam is a study of your body for signs of disease. To start, your basic body functions will be measured. These functions include your temperature, blood pressure, and pulse and breathing (respiration) rate. Your weight will also be checked. During the exam, your doctor will listen to your lungs, heart, and gut. Your doctor will also look at and feel parts of your body. This is done to see if organs are of normal size, are soft or hard, or cause pain when touched. Cancer and other health conditions can cause organs to become enlarged and hard. With MPNs, your spleen and liver may be larger than normal. Blood tests Blood tests are useful for diagnosing MPN. They can help to find other diseases, too. They require a sample of your blood. Samples of blood can be removed with a blood draw. Before a blood draw, you might need to stop drinking and eating for several hours. A needle will be inserted into your vein to remove blood. The needle may bruise your skin. You may feel dizzy from the blood draw. Your blood sample will be sent to a lab. A pathologist will perform the blood tests. A pathologist is a doctor who’s an expert in testing cells to find disease. CBC with differential A CBC ( c omplete b lood c ount) measures parts of the blood. It is often done with a machine. Test results include counts of white blood cells, red blood cells, and platelets. Another result is the fraction of red blood cells to blood (hematocrit). Hemoglobin levels are also measured. Hemoglobin is a protein within red blood cells. It carries oxygen from your lungs to the rest of your body. There are several types of white blood cells. A differential counts the number of each type. It also checks if the counts are in balance with each other. Your doctor can determine the cause of an abnormal white blood count from this test. Cancer and other health problems can cause low or high counts. With MPNs, one or more cell counts are high. Hemoglobin and hematocrit levels are high in PV. Blood smear A trained specialist will look at a drop of your blood. The blood drop will first be placed on a glass slide and prepared with a stain. It will then be viewed with a microscope. This is called a blood smear. A blood smear reveals important information about your blood cells. It can show which types of cells are present. With MPN, sometimes blood-forming cells are present. These cells aren’t usually in blood. A blood smear can also reveal if the blood cells look normal or not. Finding cells with an abnormal shape or size can be a clue as to what disease you have. Comprehensive metabolic panel Chemicals in your blood come from your liver, bone, and other organs. A comprehensive metabolic panel often includes tests for up to 14 chemicals. The tests show if the level of chemicals is too low or high. Abnormal levels can be caused by cancer or other health problems. Some chemicals in the panel include: LDH LDH ( l actate d e h ydrogenase) is a protein that is in most cells. Dying cells release LDH into blood. High levels of LDH can be a sign of MF. 2 Testing for MPN Physical exam | Blood tests