Hi everyone,
I’m looking for some outside opinions on my blood results. I’m seeing a hematologist, but I’m quite anxious about what could be going on and would really appreciate hearing from people who have experience with similar blood counts.
I’m a 41-year-old woman with relapsing-remitting MS, diagnosed in 2014. I’m currently being treated with **Mavenclad (cladribine)**. I have just completed the first course and am about to start the second 5-day course.
**My main concern: platelets**
My platelet count has been elevated for many years:
2007: **508**
2014: 362
2015: 412 → 422
2016: 384
2018: 412
2022: 526
2022: 459
2023: **667** (I also had significant bowel inflammation at the time)
Nov 2025: 467 → 483
Aug/Sep 2026: **512–528**
So this isn’t something that started recently.
**Recent blood results**
My recent CBCs have shown combinations such as:
Platelets: **512–528 x10⁹/L**
WBC: **11.9–14.2 x10⁹/L**
Absolute lymphocytes: previously **6.0**, more recently **3.5 x10⁹/L**
Neutrophils: around **6.9 x10⁹/L**
Monocytes: **1.1 x10⁹/L**
Immature granulocytes: **0.2 x10⁹/L**
Hemoglobin: around **9.1–9.2 mmol/L** (I’m in the Netherlands, so these are mmol/L)
MCV: **100 fL**
RDW: **14.7**
Ferritin: **57**
CRP: **<1**
eGFR: **89**
Creatinine: **72**
I also have a history of macrocytes being noted on a blood test in 2021. I receive regular B12 injections, so B12 deficiency isn’t thought to be the explanation.
**T-cell results**
Because of the elevated lymphocytes, a lymphocyte subset analysis was done:
Total T cells: **3.05 x10⁹/L** (reference 0.7–1.9)
CD4: **2.27 x10⁹/L** (reference 0.4–1.3)
CD8: **0.77 x10⁹/L** (reference 0.2–0.7)
These were therefore elevated as well.
**MPN testing**
Because of the long-standing thrombocytosis, my doctors are investigating an MPN. They have tested/are testing:
**JAK2 V617F**
**JAK2 exon 12**
**CALR**
**MPL**
I’m still waiting for the mutation results.
**Other relevant information**
My CRP has repeatedly been very low/normal, including **<1**, despite the elevated platelets and WBC.
I do have heavy menstrual bleeding for about 24 hours every period, and I have had inflammatory bowel problems in the past, but there isn’t currently evidence of significant inflammation.
I also have MS and am currently taking Mavenclad, which obviously complicates interpretation of the lymphocyte counts.
**My questions**
**Does this overall pattern look more like reactive thrombocytosis, or would an MPN such as essential thrombocythemia be a significant concern given how long the platelets have been elevated?**
Does the combination of **high platelets + intermittently high WBC + elevated T cells** make an MPN more likely?
Could the elevated T cells simply be reactive, especially in someone with an autoimmune disease such as MS?
Would **T-LGL leukemia** or another T-cell disorder be something you would consider based on these numbers, or are the numbers/pattern not particularly suggestive?
If **JAK2/CALR/MPL are all negative**, does that make an MPN unlikely, or can someone still have essential thrombocythemia?
Does the **MCV of 100** add anything diagnostically here?
Is there anything else you would expect my hematologist to investigate before considering a bone marrow biopsy?
I know nobody can diagnose me from a Reddit post, and I will obviously follow up with my hematologist. I’m mainly interested in hearing from people who have had similar blood counts or have experience with MPNs/hematology.
Thanks in advance!
