Diagnosis

Tests and procedures used to diagnose myelofibrosis include:

• Physical exam. Your doctor will perform a physical exam. This includes a check of vital signs, such as pulse and blood pressure, as well as checks of your lymph nodes, spleen and abdomen.
• Blood tests. In myelofibrosis, a complete blood count typically shows abnormally low levels of red blood cells, a sign of anemia common in people with myelofibrosis. White blood cell and platelet counts are usually abnormal, too. Often, white blood cell levels are higher than normal, although in some people they may be normal or even lower than normal. Platelet counts may be higher or lower than normal.
• Imaging tests. Imaging tests, such as X-rays and MRI, may be used to gather more information about your myelofibrosis.

• Bone marrow examination. Bone marrow biopsy and aspiration can confirm a diagnosis of myelofibrosis.

  In a bone marrow biopsy, a needle is used to draw a sample of bone tissue and the enclosed marrow from your hipbone. During the same procedure, another type of needle may be used to withdraw a sample of the liquid portion of your bone marrow. The samples are studied in a laboratory to determine the numbers and types of cells found.

• Testing cancer cells for gene mutations. In a laboratory, doctors will analyze your blood or bone marrow cells for gene mutations, such as JAK2, CALR and MPL. Your doctor uses the information from these tests to determine your prognosis and your treatment options.